Provider Demographics
NPI:1528512894
Name:CORDIAL MEDICAL, P.C.
Entity type:Organization
Organization Name:CORDIAL MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-693-6644
Mailing Address - Street 1:22001 JAMAICA AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2140
Mailing Address - Country:US
Mailing Address - Phone:718-878-4177
Mailing Address - Fax:
Practice Address - Street 1:100 BROADHOLLOW RD STE 106
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4813
Practice Address - Country:US
Practice Address - Phone:631-693-6644
Practice Address - Fax:631-693-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty