Provider Demographics
NPI:1427320571
Name:MGS MEDICAL TECHNOLOGY PLLC
Entity type:Organization
Organization Name:MGS MEDICAL TECHNOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAHMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-460-2876
Mailing Address - Street 1:14415 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2318
Mailing Address - Country:US
Mailing Address - Phone:718-460-2876
Mailing Address - Fax:
Practice Address - Street 1:4359 147TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1741
Practice Address - Country:US
Practice Address - Phone:718-445-1205
Practice Address - Fax:718-445-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215618171100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY215618OtherLICENSE