Provider Demographics
NPI:1669753968
Name:OMEGA PLUS MEDICAL P.C.
Entity type:Organization
Organization Name:OMEGA PLUS MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BYALIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-668-6819
Mailing Address - Street 1:3914 JANE LN
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5929
Mailing Address - Country:US
Mailing Address - Phone:347-668-6819
Mailing Address - Fax:888-270-0981
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:SUITE 1420
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3001
Practice Address - Country:US
Practice Address - Phone:347-668-6819
Practice Address - Fax:888-270-0981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258389207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty