Organization
300 OLD COUNTRY ROAD MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE TYDINGS MD (MEDICAL DIRECTOR)
(516) 702-4924
Entity
Organization
Contact information
Practice address
300 OLD COUNTRY RD STE 201, MINEOLA, NY 11501-4199
(516) 702-4924
Mailing address
1231 MOORES HILL RD, SYOSSET, NY 11791-9631
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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