Provider Demographics
NPI:1972339851
Name:SUAREZ FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:SUAREZ FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:HERNAN
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-377-2727
Mailing Address - Street 1:72 GUY LOMBARDO AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3742
Mailing Address - Country:US
Mailing Address - Phone:516-377-2727
Mailing Address - Fax:516-377-8088
Practice Address - Street 1:72 GUY LOMBARDO AVE STE 1
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3742
Practice Address - Country:US
Practice Address - Phone:516-377-2727
Practice Address - Fax:516-377-8088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERGIO G. SUAREZ PHYSICIAN PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty