Imam Medical PC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

159557-1 Issued in NY

Legal business name

IMAM MEDICAL PC

Doing business as

The CIIT Center of Center Moriches

Practice address

2 Union Ave
Center Moriches, NY 11934-3324

Phone

(631) 645-3613

NPI assigned

Jan 23, 2017

Last updated

Feb 21, 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

Bruce Weitzberg

Title

Business Manager

Phone

(516) 243-8660

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The CIIT Center of Center Moriches Doing business as

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1386181840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SUNNYSIDE BLVD STE 100",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031539",
            "telephone_number": "516-243-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNION AVE",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343324",
            "telephone_number": "631-645-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAM MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "WEITZBERG",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "516-243-8660"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "159557-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144394826",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The CIIT Center of Center Moriches",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William M. Herro, PT
• Kristy Ann Higgins, LMT
• Christopher Joseph Hildebrandt, ATC
• Anne Hodgins
• Julie A Hyers, M.S. ED.
• Muneer Imam, M.D.
• Independent Group Home Living
• Galina Jeranek, RPH
• Joan Stong LCSW PLLC
• Judith S Savino DMD William a Savino Jr DDS PC

• Pulmonary Disease Physician in Center Moriches, NY
• Providers in Center Moriches, NY by specialty
• Pulmonary Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.