Provider Demographics
NPI:1982879326
Name:5TOWNS MEDICAL CARE PC
Entity Type:Organization
Organization Name:5TOWNS MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BOGDAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEGREA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-812-9288
Mailing Address - Street 1:951 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1733
Mailing Address - Country:US
Mailing Address - Phone:516-812-9288
Mailing Address - Fax:
Practice Address - Street 1:951 BROADWAY
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1733
Practice Address - Country:US
Practice Address - Phone:516-812-9288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206703204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000091Medicare PIN