Dr. Mohamed Idris Medical PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

228816 Issued in NY

Legal business name

DR. MOHAMED IDRIS MEDICAL PC

Practice address

55 N Main St
Freeport, NY 11520-2243

Phone

(516) 538-0295

Fax

(516) 538-0296

NPI assigned

Sep 13, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohamed Hussein Idris, M.D.

Title

Owner

Phone

(516) 582-8356

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1053628933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BALFOUR DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145527",
            "telephone_number": "516-538-0295",
            "fax_number": "516-538-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202243",
            "telephone_number": "516-538-0295",
            "fax_number": "516-538-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MOHAMED IDRIS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "IDRIS",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "HUSSEIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-582-8356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "228816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin M. Dorn, LCSW
• Cherise Dorsey, RN
• Deshanti T Dortch
• Natasha Dowlat, LMSW
• Dr. Louis Marc Charles
• Kasha Dragon
• Latasha Drones
• Loretta Drummond
• Marsha Patrice Drummond, NURSE PRACTITIONER
• Natalia Cristina Duffy

• Endocrinology, Diabetes & Metabolism Physician in Freeport, NY
• Providers in Freeport, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.