Main Street Primary Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAIN STREET PRIMARY MEDICINE

Practice address

475 E Main St Ste 103
Patchogue, NY 11772-3121

Phone

(631) 447-6100

Fax

(631) 447-6126

NPI assigned

Oct 28, 2007

Last updated

Oct 28, 2007By 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. Christopher Garenani, M.D.

Title

President/Owner

Phone

(631) 428-3369

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Eric Jacobson, MD

  • Physical Medicine & Rehabilitation Physician
  • Bronx, NY
  • NPI 1477699692
  NPD (past)

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

{
    "created_epoch": "1193529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193529600000",
    "number": "1932388873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 993",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117410993",
            "telephone_number": "631-447-6100",
            "fax_number": "631-758-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST STE 103",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "631-447-6100",
            "fax_number": "631-447-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PRIMARY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-28",
        "last_updated": "2007-10-28",
        "status": "A",
        "authorized_official_last_name": "GARENANI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "631-428-3369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felisa Mahabal
• Elnaz Mahbub, DO
• Jennifer Mahon, REGISTERED NURSE
• Main St. Med Care PC
• Main Street Medical Imaging, PC
• Jayeshkumar Makavana, MD
• Nita Krishna Malik, N.P.
• Gary D Mancuso, RPH
• Gloria Kay Mancuso, OG NP
• Mary Ashley Manetta, PHYSICIAN ASSISTANT

• Family Medicine Physician in Patchogue, NY
• Providers in Patchogue, 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 Oct 28, 2007; 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.