Healthsource Medical Services Medford, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

167755 Issued in NY

Legal business name

HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC

Practice address

1743 N Ocean Ave
Medford, NY 11763-2649

Phone

(631) 758-3100

Fax

(631) 758-3168

NPI assigned

Jun 17, 2010

Last updated

Jun 17, 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. John Folan, M.D.

Title

President/Owner

Phone

(631) 435-0110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1821319575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXPRESS DR N",
            "address_2": "SUITE 200C",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-435-0110",
            "fax_number": "631-435-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-758-3100",
            "fax_number": "631-758-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "FOLAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "631-435-0110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "167755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Hartman
• Araine Cadine Hawthorne, RN
• Janya Hazzard-Angevine
• Health East Inc
• Health Studio
• Roenell Thomas Heerbrandt, DO
• Ecaterina Henter, LMSW
• Sasha Gail Hernandez, RN
• Lynn P Hillery, MS RD CDN
• Austin Hines, RN

• Internal Medicine Physician in Medford, NY
• Providers in Medford, 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 Jun 17, 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.