Organization
MEDICAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMADUDDIN HASHMI M.D. (MEDICAL DIRECTOR)
(718) 306-5025
Entity
Organization
Contact information
Practice address
120 OLD FARMERS LN, STATEN ISLAND, NY 10304-1404
(718) 306-5025
(718) 462-8000
Mailing address
62 NEW ST, LYNBROOK, NY 11563-3309
(718) 306-5025
(718) 462-8000
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
184579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01359457
—
NY
Enumeration date
02/13/2006
Last updated
02/14/2022
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