Provider Demographics
NPI:1689083826
Name:PRESTIGE MEDICAL PHYSICIANS, PLLC
Entity Type:Organization
Organization Name:PRESTIGE MEDICAL PHYSICIANS, PLLC
Other - Org Name:HIVE MOBILE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-312-0231
Mailing Address - Street 1:20 AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2202
Mailing Address - Country:US
Mailing Address - Phone:516-351-2213
Mailing Address - Fax:888-202-2608
Practice Address - Street 1:175 I U WILLETS RD STE 2B
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1342
Practice Address - Country:US
Practice Address - Phone:516-351-2213
Practice Address - Fax:888-202-2608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238889261Q00000X, 261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty