1717 Medical Pc

LBN: 1717 Medical Pc
1717 Medical Pc is an health care organization with primary practice located at 1717 Veterans Memorial Hwy Ste 1 , Islandia NY 11749-1532. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. 1717 Medical Pc can be contacted via phone (631) 203-4300, or through Sudberg, Jordan via phone (631) 482-2754.

Contact Information

Primary practice address
1717 Veterans Memorial Hwy Ste 1 Islandia NY 11749-1532
Phone: (631) 203-4300
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Sudberg, Jordan Doctor of Medicine (MD)
Phone: (631) 482-2754

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X

Profile Details

NPI number 1467134684
LBN Legal business name 1717 Medical Pc
DBA Doing business as
Authorized official Sudberg, Jordan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 7th, 2023
Last updated Aug 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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