Provider Demographics
NPI:1104642206
Name:HEALTHY MEDICAL SERVICES
Entity type:Organization
Organization Name:HEALTHY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIZA
Authorized Official - Middle Name:F
Authorized Official - Last Name:PETRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-553-2700
Mailing Address - Street 1:1188 WILLIS AVE STE 809
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1214 5TH AVE APT 38E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5257
Practice Address - Country:US
Practice Address - Phone:917-553-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-23
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty