OrganizationActive
210 Mineola Medical PC
NPI 1821566969 · Family Medicine Physician · Mineola, NY
Provider details
- NPI number
- 1821566969
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Irena Musheev, Credentialing Coordinator(516) 612-9837
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
210 Old Country Rd
Mineola, NY 11501-4218
Phone: (516) 279-4400
Approximate (ZIP-level) locationGet directions
Mailing address
211 Broadway Ste 205
Lynbrook, NY 11563-3290
Registry dates
- Enumerated
- 2018-11-07
- Last updated
- 2018-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.