Provider Demographics
NPI:1104048750
Name:NORWIND MEDICAL, P.C.
Entity type:Organization
Organization Name:NORWIND MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILBOOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-5394
Mailing Address - Street 1:1979 MARCUS AVENUE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-627-5394
Mailing Address - Fax:718-366-0011
Practice Address - Street 1:1979 MARCUS AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-627-5394
Practice Address - Fax:718-366-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA200413-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty