210 Mineola Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

210 MINEOLA MEDICAL PC

Practice address

210 Old Country Rd
Mineola, NY 11501-4218

Phone

(516) 279-4400

NPI assigned

Nov 7, 2018

Last updated

Nov 7, 2018By 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

Irena Musheev

Title

Credentialing Coordinator

Phone

(516) 612-9837

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Ana M Ghelechkhani, PA

  • Medical Physician Assistant
  • Flushing, NY
  • NPI 1003050782
  NPD (past)
• Christina Josephine Megerian, NP

  • Family Nurse Practitioner
  • Mineola, NY
  • NPI 1275022139
  NPD (past)
• Elcy Santosh, FNP

  • Family Nurse Practitioner
  • Mineola, NY
  • NPI 1689153199
  NPD (past)

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1821566969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BROADWAY STE 205",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OLD COUNTRY RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014218",
            "telephone_number": "516-279-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "210 MINEOLA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "MUSHEEV",
        "authorized_official_first_name": "IRENA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "516-612-9837"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 300 Old Country Road Medical PLLC
• 48TH Sean Kims Chiropractic PC
• A-1 Surgical and Medical Supplies Inc
• Tzvi H Aaron, MD
• Oleg Abayev, DPT

• Family Medicine Physician in Mineola, NY
• Providers in Mineola, 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 Nov 7, 2018; 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.