Provider Demographics
NPI:1932353265
Name:AUSTIN FP
Entity Type:Organization
Organization Name:AUSTIN FP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-227-3377
Mailing Address - Street 1:901 STEWART AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4893
Mailing Address - Country:US
Mailing Address - Phone:516-227-3377
Mailing Address - Fax:
Practice Address - Street 1:901 STEWART AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4893
Practice Address - Country:US
Practice Address - Phone:516-227-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176620261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical