Provider Demographics
NPI:1346420817
Name:UNIVERSAL FAMILY MEDICAL CARE, PC
Entity Type:Organization
Organization Name:UNIVERSAL FAMILY MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHIKARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-206-2901
Mailing Address - Street 1:340 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8404
Mailing Address - Country:US
Mailing Address - Phone:631-206-2901
Mailing Address - Fax:631-206-0168
Practice Address - Street 1:340 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8404
Practice Address - Country:US
Practice Address - Phone:631-206-2901
Practice Address - Fax:631-206-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty