Provider Demographics
NPI:1578865341
Name:SKENDER MURTEZANI, MD PLLC
Entity Type:Organization
Organization Name:SKENDER MURTEZANI, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SKENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTEZANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-461-3065
Mailing Address - Street 1:13816 57TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5225
Mailing Address - Country:US
Mailing Address - Phone:718-461-3065
Mailing Address - Fax:
Practice Address - Street 1:13816 57TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5225
Practice Address - Country:US
Practice Address - Phone:718-461-3065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1962550699OtherNPI
NYI36633Medicare UPIN