The Med Station PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE MED STATION PC

Practice address

104 Forest Ave
Glen Cove, NY 11542-2015

Phone

(516) 759-5406

Fax

(516) 759-5537

NPI assigned

Jun 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell H Samuel, M.D.

Title

Owner

Phone

(516) 759-5406

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1992900583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422015",
            "telephone_number": "516-759-5406",
            "fax_number": "516-759-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FOREST AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422015",
            "telephone_number": "516-759-5406",
            "fax_number": "516-759-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MED STATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-759-5406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirza Tanovic, MD
• Bernard Tawfik
• Priscila Lorena Tenesaca I
• Jaclyn Teresco, PA
• The Humanitarian Resource Foundation International Inc
• Aimee Teresa Thomas
• Janine Thomesen, NP
• James Thompson, MD
• Ellenmorris Tiegerman-Farber, PH.D.; LMSW
• Stephanie Torres, RN

• Internal Medicine Physician in Glen Cove, NY
• Providers in Glen Cove, 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 May 7, 2008; 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.