O'Rourke, Innis

O'Rourke, Innis is an individual health care provider with primary practice located at 3 School St Suite 101-A, Glen Cove NY 11542-2548. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. O'Rourke, Innis can be contacted via phone (516) 674-2121.

Contact Information

Primary practice address
3 School St Suite 101-A Glen Cove NY 11542-2548
Phone: (516) 674-2121
Fax: (516) 674-2260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 151488 New York

Profile Details

NPI number 1346278215
LBN Legal business name O'Rourke, Innis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346278215 NPPES
New York MEDICAID 00783248

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