125 Liberty Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

214856-1 Issued in NY

Legal business name

125 LIBERTY MEDICAL PLLC

Practice address

12507 Liberty Ave
South Richmond Hill, NY 11419-2233

Phone

(718) 845-8900

Fax

(718) 845-0148

NPI assigned

Jul 16, 2010

Last updated

Jul 19, 2010By 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. Muntaz Majeed, MD

Title

Director

Phone

(718) 843-9100

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip Roopchan Baldeo, MD

  • Family Medicine Physician
  • Richmond Hill, NY
  • NPI 1003992033
  NPD

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279497600000",
    "number": "1386957546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12507 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114192233",
            "telephone_number": "718-845-8900",
            "fax_number": "718-845-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12507 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114192233",
            "telephone_number": "718-845-8900",
            "fax_number": "718-845-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "125 LIBERTY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-19",
        "status": "A",
        "authorized_official_last_name": "MAJEED",
        "authorized_official_first_name": "MUNTAZ",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-843-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214856-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 12116 Liberty Avenue Drugs Inc. (CPW Pharmacy)
• 786 United Inc. (New Clear Vision Optical)
• A & J Pharmacy and Surgical Supplies Inc (A & J Pharmacy & Surgical Supplies Inc)
• Abihas International Corp
• Winston Abraham, RPH
• Mehar Afshan Ahmad, RPH

• Family Medicine Physician in South Richmond Hill, NY
• Providers in South Richmond Hill, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.