Provider Demographics
NPI:1457963241
Name:MEDICAL SERVICES OF UNIONDALE, PC
Entity Type:Organization
Organization Name:MEDICAL SERVICES OF UNIONDALE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT & CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUSACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-321-6058
Mailing Address - Street 1:106 CHARLES LINDBERGH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3632
Mailing Address - Country:US
Mailing Address - Phone:516-248-3737
Mailing Address - Fax:866-540-1163
Practice Address - Street 1:106 CHARLES LINDBERGH BLVD STE B
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3632
Practice Address - Country:US
Practice Address - Phone:516-248-3737
Practice Address - Fax:866-540-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty