Provider Demographics
NPI:1699978627
Name:AUSTIN MEDICAL ASSOCIATES PC
Entity type:Organization
Organization Name:AUSTIN MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOSNOWIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-830-9500
Mailing Address - Street 1:7010 AUSTIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4763
Mailing Address - Country:US
Mailing Address - Phone:718-830-9500
Mailing Address - Fax:718-793-8407
Practice Address - Street 1:7010 AUSTIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4763
Practice Address - Country:US
Practice Address - Phone:718-830-9500
Practice Address - Fax:718-793-8407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165028207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61107Medicare UPIN
NY24820Medicare ID - Type Unspecified
NYE40744Medicare UPIN