Organization
1ST MED AND DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVRAM SHAPIRO (ADMINISTRATOR)
(516) 620-4246
Entity
Organization
Contact information
Practice address
4029A 235TH ST, DOUGLASTON, NY 11363-1509
(516) 620-4246
(516) 620-6807
Mailing address
4029A 235TH ST, DOUGLASTON, NY 11363-1509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
196473
NY
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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