Provider Demographics
NPI:1346992906
Name:NEW HILLSIDE MEDICAL LLC
Entity Type:Organization
Organization Name:NEW HILLSIDE MEDICAL LLC
Other - Org Name:CROSS ISLAND MEDICAL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIMANSHU
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-903-3885
Mailing Address - Street 1:427 LINKS DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3079
Mailing Address - Country:US
Mailing Address - Phone:917-903-3885
Mailing Address - Fax:
Practice Address - Street 1:25720 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004-1653
Practice Address - Country:US
Practice Address - Phone:718-831-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherINTERNAL MEDICINE