Provider Demographics
NPI:1649604661
Name:V-MEDICAL PC
Entity type:Organization
Organization Name:V-MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:HINZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-586-6087
Mailing Address - Street 1:1069 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FRANKLIN SQ
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2631
Mailing Address - Country:US
Mailing Address - Phone:516-586-6087
Mailing Address - Fax:631-792-7011
Practice Address - Street 1:1069 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 4
Practice Address - City:FRANKLIN SQ
Practice Address - State:NY
Practice Address - Zip Code:11010-2631
Practice Address - Country:US
Practice Address - Phone:516-586-6087
Practice Address - Fax:631-792-7011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2427982081P2900X, 2081P2900X
NY215852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY242798A72OtherHEALTHFIRST
NY100292329407OtherUNITED HEALTHCARE COMMUNITY PLAN
NY242798OtherHEALTHCARE PARTNERS
NY242498OtherEMBLEM HEALTH
NY242798OtherHIP
NY8518030POtherHIP NY
NY958221Medicare PIN