OrganizationActive
1717 Medical PC
NPI 1467134684 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Islandia, NY
Provider details
- NPI number
- 1467134684
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Jordan Sudberg, Owner
Practice location
1717 Veterans Memorial Hwy Ste 1
Islandia, NY 11749-1532
Phone: (631) 203-4300
Mailing address
1717 Veterans Memorial Hwy Ste 1
Islandia, NY 11749-1532
Registry dates
- Enumerated
- 2023-08-07
- Last updated
- 2023-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.