Organization
COMMUNITY MEDICAL DISORDER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERBERT MORTON MEADOW MD (PRESIDENT)
(718) 218-6888
Entity
Organization
Contact information
Practice address
721 FLUSHING AVE, 1ST FLOOR, BROOKLYN, NY 11206-4419
(718) 218-6888
(718) 218-6855
Mailing address
721 FLUSHING AVE, 1ST FLOOR, BROOKLYN, NY 11206-4419
(718) 218-6888
(718) 218-6855
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
090294
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03345420
—
NY
01
—
A400067616
MEDICARE PTAN
NY
Enumeration date
05/23/2013
Last updated
07/26/2013
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