Main Street Internal Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

234668 Issued in NY

Legal business name

MAIN STREET INTERNAL MEDICINE, PLLC

Practice address

124 Main St
Suite 12
Huntington, NY 11743-6922

Phone

(631) 271-6406

NPI assigned

May 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michel William Ghobrial, M.D.NPI 1083663744

Title

President

Phone

(631) 271-6406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Michel William Ghobrial, M.D.

  • Internal Medicine Physician
  • Huntington, NY
  • NPI 1083663744

  Internal Medicine, NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760433759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "address_2": "SUITE 12",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436922",
            "telephone_number": "631-271-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "address_2": "SUITE 12",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436922",
            "telephone_number": "631-271-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHOBRIAL",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-271-6406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheena Mago
• Samantha Leigh Maietta, LCSW
• Lawrence L. Mailloux, DDS
• Main Source Pharmacy Inc
• Main Source Pharmacy Inc
• Robert James Maiorino, DDS
• Sohail Majid, DPM
• Denise A. Maletta, L.AC./LMT
• Radhika Malhotra, MD
• Faiza Kamal Mallick, MD

• All providers in Huntington, NY
• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.