Organization
WHITE MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT EDMUND WHITE M.D. (PRESIDENT)
(718) 635-1210
Entity
Organization
Contact information
Practice address
11905 80TH RD, KEW GARDENS, NY 11415-1105
(718) 635-1210
(718) 663-7134
Mailing address
11905 80TH RD, KEW GARDENS, NY 11415-1105
(718) 635-1210
(718) 663-7134
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
163661
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07373A
MEDICARE ID
NY
Enumeration date
07/21/2006
Last updated
03/01/2013
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