Provider profile · NPI 1821566969

210 Mineola Medical Pc

Family Medicine · Mineola, NY · NPI 1821566969 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Family Medicine

Enumerated

Nov 7, 2018

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILING211 BROADWAY STE 205 Lynbrook, NY 11563-3290
LOCATION210 OLD COUNTRY RD Mineola, NY 11501-4218516-279-4400

View on NPPES registry ↗

Watch this provider

Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.