Provider Demographics
NPI:1316499684
Name:PRECISION MEDICAL ARTS OF NEW YORK PLLC
Entity type:Organization
Organization Name:PRECISION MEDICAL ARTS OF NEW YORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KIRIDLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-366-2220
Mailing Address - Street 1:267 E MAIN ST
Mailing Address - Street 2:BLDG B3
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2874
Mailing Address - Country:US
Mailing Address - Phone:631-366-2220
Mailing Address - Fax:631-366-1018
Practice Address - Street 1:267 E MAIN ST
Practice Address - Street 2:BLDG B3
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2874
Practice Address - Country:US
Practice Address - Phone:631-366-2220
Practice Address - Fax:631-366-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168297174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty