Provider Demographics
NPI:1336357904
Name:UNIVERSALFAMILY MEDICINE PC
Entity Type:Organization
Organization Name:UNIVERSALFAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-793-0874
Mailing Address - Street 1:10 GREENWAY
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-4604
Mailing Address - Country:US
Mailing Address - Phone:718-793-0874
Mailing Address - Fax:718-793-9267
Practice Address - Street 1:10917 72ND RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5336
Practice Address - Country:US
Practice Address - Phone:718-793-0874
Practice Address - Fax:718-793-9267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty