Provider Demographics
NPI:1982976999
Name:EXPRESS MEDICAL CARE, P.C
Entity type:Organization
Organization Name:EXPRESS MEDICAL CARE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAMYA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-351-3331
Mailing Address - Street 1:357 BROADWAY
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2748
Mailing Address - Country:US
Mailing Address - Phone:631-789-7900
Mailing Address - Fax:631-608-8492
Practice Address - Street 1:.357 BROADWAY
Practice Address - Street 2:SUITE 2C
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-789-7900
Practice Address - Fax:631-608-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204874207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG22061Medicare UPIN