Provider Demographics
NPI:1316000466
Name:NEW HYDE PARK INTERNAL MEDICINE SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:NEW HYDE PARK INTERNAL MEDICINE SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-437-1616
Mailing Address - Street 1:1575 HILLSIDE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2501
Mailing Address - Country:US
Mailing Address - Phone:516-437-1616
Mailing Address - Fax:516-354-6048
Practice Address - Street 1:1575 HILLSIDE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2501
Practice Address - Country:US
Practice Address - Phone:516-437-1616
Practice Address - Fax:516-354-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID. NUMBER
NYW03751Medicare PIN
NYCF6410Medicare PIN
NY=========OtherTAX ID. NUMBER