Organization
MEDFORD DIALYSIS ACCESS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PURSHOTAM LAL NAGWANI M.D. (PRESIDENT/OWNER)
(631) 732-4600
Entity
Organization
Contact information
Practice address
3241 ROUTE 112, BLDG #7, MEDFORD, NY 11763-1434
(631) 732-4600
(631) 732-4656
Mailing address
80 HILLDALE RD, ALBERTSON, NY 11507-2214
(516) 640-5656
(516) 640-5656
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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