Provider Demographics
NPI:1922136571
Name:WESTBURY MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:WESTBURY MEDICAL CARE, P.C.
Other - Org Name:WESTBURY TOTAL HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-333-3253
Mailing Address - Street 1:355 POST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2265
Mailing Address - Country:US
Mailing Address - Phone:516-333-3253
Mailing Address - Fax:516-333-8452
Practice Address - Street 1:355 POST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2265
Practice Address - Country:US
Practice Address - Phone:516-333-3253
Practice Address - Fax:516-333-8452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW35451Medicare ID - Type UnspecifiedGROUP NUMBER