Provider Demographics
NPI:1558956516
Name:NYS PHYSICIAN ASSISTANT CONSULTING PC
Entity Type:Organization
Organization Name:NYS PHYSICIAN ASSISTANT CONSULTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:YAHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:631-831-2313
Mailing Address - Street 1:121 CISNEY AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3214
Mailing Address - Country:US
Mailing Address - Phone:631-831-2313
Mailing Address - Fax:
Practice Address - Street 1:121 CISNEY AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3214
Practice Address - Country:US
Practice Address - Phone:631-831-2313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain