Hicksville Primary Medical Care PLLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

HICKSVILLE PRIMARY MEDICAL CARE PLLC

Practice address

380 S Broadway
Hicksville, NY 11801-5033

Phone

(516) 937-7600

Fax

(718) 343-7603

NPI assigned

Feb 21, 2019

Last updated

Feb 21, 2019By 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

Ankur Patel

Title

Credentialing Coordinator

Phone

(908) 966-7395

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1598222960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015033",
            "telephone_number": "516-937-7600",
            "fax_number": "718-343-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015033",
            "telephone_number": "516-937-7600",
            "fax_number": "718-343-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKSVILLE PRIMARY MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "908-966-7395"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "225462",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hicksville Medical Care, PC
• Hicksville Medical Services, P.C.
• Hicksville Optical Inc.
• Hicksville Pediatrics PC
• Hicksville Pediatrics Physician PC
• Hicksville Primary Medical Oc
• Hicksville Public Schools
• Hicksville RX Inc.
• Hicksville Vision Express LLC (Cohens Fashion Optical)
• Faisal Hilaby

• Geriatric Medicine (Internal Medicine) Physician in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Geriatric Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.