33D2110641 CLIA NUMBER - HEALTH EDGE MEDICAL CARE PLLC

Laboratory Demographics

CLIA Number: 33D2110641

Facility Name: HEALTH EDGE MEDICAL CARE PLLC

Facility Address:
504 MEDFORD AVENUE
PATCHOGUE, NY
ZIP 11772
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Facility Phone Number: 631 475-4646

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821403387

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name	Field Value
CLIA Number	33D2110641
LAB Type	Physician Office
Facility Name	HEALTH EDGE MEDICAL CARE PLLC
Street	504 MEDFORD AVENUE
City	PATCHOGUE
State	NY
ZIP	11772
Phone	631 475-4646
CertificateType	4
CertificateEffectiveDate	3/22/2024
CertificateExpirationDate	3/21/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024