300 Old Country Road Medical PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

300 OLD COUNTRY ROAD MEDICAL PLLC

Practice address

300 Old Country Rd Ste 201
Mineola, NY 11501-4199

Phone

(516) 702-4924

NPI assigned

Nov 10, 2017

Last updated

Nov 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Tydings, MD

Title

Medical Director

Phone

(516) 702-4924

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1164935276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 MOORES HILL RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117919631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD STE 201",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014199",
            "telephone_number": "516-702-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "300 OLD COUNTRY ROAD MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "TYDINGS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-702-4924",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.