Provider Demographics
NPI:1255496899
Name:HEMPSTEAD MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:HEMPSTEAD MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:VISO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-751-5588
Mailing Address - Street 1:1890 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2904
Mailing Address - Country:US
Mailing Address - Phone:631-427-6920
Mailing Address - Fax:631-425-0653
Practice Address - Street 1:95 CLINTON ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4211
Practice Address - Country:US
Practice Address - Phone:516-292-0800
Practice Address - Fax:516-564-4856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty