Provider Demographics
NPI:1639447725
Name:HUGUENOT MEDICAL SERVICES P.C.
Entity Type:Organization
Organization Name:HUGUENOT MEDICAL SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELSOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-948-5475
Mailing Address - Street 1:4459 AMBOY RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3846
Mailing Address - Country:US
Mailing Address - Phone:718-948-6177
Mailing Address - Fax:718-948-8189
Practice Address - Street 1:5405 HYLAN BLVD
Practice Address - Street 2:STUITE 1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5201
Practice Address - Country:US
Practice Address - Phone:718-948-5475
Practice Address - Fax:718-948-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty