Provider Demographics
NPI:1427606649
Name:NEW HEALTH MEDICAL PC
Entity type:Organization
Organization Name:NEW HEALTH MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NENAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRLIC
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-804-8217
Mailing Address - Street 1:143 WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1141
Mailing Address - Country:US
Mailing Address - Phone:347-804-8217
Mailing Address - Fax:
Practice Address - Street 1:143 WICKHAM RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1141
Practice Address - Country:US
Practice Address - Phone:347-804-8217
Practice Address - Fax:516-750-5414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06868551Medicaid