Provider Demographics
NPI:1740040799
Name:COUNTERPOINT MEDICAL P.C
Entity type:Organization
Organization Name:COUNTERPOINT MEDICAL P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RUALES
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:516-306-3434
Mailing Address - Street 1:12A GRAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1594
Mailing Address - Country:US
Mailing Address - Phone:516-306-3434
Mailing Address - Fax:
Practice Address - Street 1:12A GRAYWOOD RD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1594
Practice Address - Country:US
Practice Address - Phone:516-306-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No251E00000XAgenciesHome Health
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical