Provider Demographics
NPI:1427300045
Name:REX MEDICAL PC
Entity type:Organization
Organization Name:REX MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRISH
Authorized Official - Middle Name:N
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-830-0714
Mailing Address - Street 1:878 DANA AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1305
Mailing Address - Country:US
Mailing Address - Phone:516-830-0174
Mailing Address - Fax:877-249-8603
Practice Address - Street 1:878 DANA AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-830-0174
Practice Address - Fax:877-249-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166869207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty