Provider Demographics
NPI:1356619621
Name:FRANKLIN MEDICAL CARE PC
Entity type:Organization
Organization Name:FRANKLIN MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THIRUMALESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VENKATESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:516-354-2707
Mailing Address - Street 1:113 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2524
Mailing Address - Country:US
Mailing Address - Phone:516-354-2707
Mailing Address - Fax:516-354-2135
Practice Address - Street 1:113 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-2524
Practice Address - Country:US
Practice Address - Phone:516-354-2707
Practice Address - Fax:516-354-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02669170Medicaid
NYI 1289Medicare UPIN