Provider Demographics
NPI:1821487265
Name:AMDO MEDICAL PC
Entity Type:Organization
Organization Name:AMDO MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-656-3930
Mailing Address - Street 1:111-09 66RD
Mailing Address - Street 2:3B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:917-656-3930
Mailing Address - Fax:
Practice Address - Street 1:13639 37TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4110
Practice Address - Country:US
Practice Address - Phone:718-886-8175
Practice Address - Fax:718-886-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty