Organization
SHAMROCK81 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD S OBEDIAN MD (PRESIDENT)
(516) 933-4350
Entity
Organization
Contact information
Practice address
81 N BROADWAY, HICKSVILLE, NY 11801-2920
(516) 933-4350
(516) 933-4352
Mailing address
PO BOX 1118, SYOSSET, NY 11791-0489
(516) 933-4350
(516) 933-4352
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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