Great Neck Medicine PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

260969 Issued in NY

Legal business name

GREAT NECK MEDICINE PC

Practice address

290 Community Dr
Great Neck, NY 11021-5504

Phone

(516) 487-1902

Fax

(516) 487-4156

NPI assigned

Dec 12, 2013

Organization subpart

No

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

Authorized official

Name

Russell Surasky, DO

Title

President

Phone

(516) 487-1902

Specialties & licenses 1

Addresses

Tax ID family

Great Neck Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Great Neck Medicine, PC

  • Clinic/Center
  • Great Neck, NY
  • NPI 1629479324
  NPD tax ID

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1942631270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 COMMUNITY DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 COMMUNITY DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215504",
            "telephone_number": "516-487-1902",
            "fax_number": "516-487-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT NECK MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "SURASKY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-487-1902",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "260969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Neck Imaging
• Great Neck Medical Care, P.C.
• Great Neck Medical Group, LLP
• Great Neck Medical Psychiatry Associates, PC
• Great Neck Medical, P.C.
• Great Neck Medicine, PC
• Great Neck Neurological Surgery, P.C.
• Great Neck Ny Medical PLLC
• Great Neck Obstetrics & Gynecology PC
• Great Neck Occupational Therapy

• Specialist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.