Provider Demographics
NPI:1962886259
Name:HEALTH 1 MEDICAL P.C.
Entity type:Organization
Organization Name:HEALTH 1 MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-580-1000
Mailing Address - Street 1:2780 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2124
Mailing Address - Country:US
Mailing Address - Phone:631-580-1000
Mailing Address - Fax:631-580-0483
Practice Address - Street 1:2780 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 140
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2124
Practice Address - Country:US
Practice Address - Phone:631-580-1000
Practice Address - Fax:631-580-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001621171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty