Glen Head Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

126797 Issued in NY

Legal business name

GLEN HEAD MEDICAL PC

Practice address

333 Glen Head Rd
Suite 150
Old Brookville, NY 11545

Phone

(516) 609-2848

Fax

(516) 609-2908

NPI assigned

Jul 3, 2007

Organization subpart

No

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

Authorized official

Name

Teodoro Yu Pang, MD

Title

Owner

Phone

(516) 609-2908

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip B Kossover, D.C.

  • Chiropractor
  • Glen Head, NY
  • NPI 1598914673
  NPD (past)
• Timothy Li, ACUPUNCTURIST

  • Acupuncturist
  • Old Brookville, NY
  • NPI 1104013648
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689872491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD",
            "address_2": "SUITE 150",
            "city": "OLD BROOKVILLE",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-609-2848",
            "fax_number": "516-609-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD",
            "address_2": "SUITE 150",
            "city": "OLD BROOKVILLE",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-609-2848",
            "fax_number": "516-609-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN HEAD MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANG",
        "authorized_official_first_name": "TEODORO",
        "authorized_official_middle_name": "YU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-609-2908",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian S. Margolis DDS PC (Periodontal Associates of Long Island)
• Catherine Chin, LMT
• Bruce Martin Jaslow, DDS
• Timothy Li, ACUPUNCTURIST
• Brian S Margolis, DDS
• Karen Wachsberg Mallin, LICENSED CLINICAL SO

• Internal Medicine Physician in Old Brookville, NY
• Providers in Old Brookville, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.