Organization
GLEN OAK MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAIRA KHALID SHAHAB M.D. (OWNER)
(516) 270-4729
Entity
Organization
Contact information
Practice address
26205 HILLSIDE AVE, FLORAL PARK, NY 11004-1756
(516) 270-4729
(516) 833-7470
Mailing address
126 BIRCH DR, NEW HYDE PARK, NY 11040-2320
(516) 270-4729
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
230853-1
NY
207RI0200X
Infectious Disease Physician
Primary
230853-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02743593
—
NY
Enumeration date
07/29/2014
Last updated
07/29/2014
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