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Organization

GLEN OAK MEDICAL CARE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAIRA K SHAHAB MD (OWNER)
(516) 270-4742
Entity
Organization

Contact information

Practice address
262-05 HILLSIDE AVE, GLEN OAKS, NY 11004
(718) 343-6100
(516) 833-7470
Mailing address
26205 HILLSIDE AVE, GLEN OAKS, NY 11004-1756
(718) 343-6100
(516) 833-7470

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
230853-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2743593
NY
Enumeration date
11/24/2015
Last updated
05/25/2016
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