Provider Demographics
NPI:1508244104
Name:GLOBAL HEALTH ADVANTAGE, INC
Entity Type:Organization
Organization Name:GLOBAL HEALTH ADVANTAGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:C
Authorized Official - Last Name:IDEYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-343-2045
Mailing Address - Street 1:250 COOK ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3504
Mailing Address - Country:US
Mailing Address - Phone:718-343-2045
Mailing Address - Fax:
Practice Address - Street 1:24739 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1541
Practice Address - Country:US
Practice Address - Phone:718-343-2045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2307442086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty