Provider Demographics
NPI:1881119634
Name:MEDICAL 360 HOUSE CALL, PLLC
Entity type:Organization
Organization Name:MEDICAL 360 HOUSE CALL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-312-0231
Mailing Address - Street 1:20 AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2202
Mailing Address - Country:US
Mailing Address - Phone:516-351-2213
Mailing Address - Fax:888-202-2608
Practice Address - Street 1:185 OLD COUNTRY RD STE 7
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2121
Practice Address - Country:US
Practice Address - Phone:631-494-2215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-12
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine