Provider Demographics
NPI:1760204242
Name:MANAL HEGAZY MD PC
Entity type:Organization
Organization Name:MANAL HEGAZY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGAZY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-581-4400
Mailing Address - Street 1:65 AWIXA AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8801
Mailing Address - Country:US
Mailing Address - Phone:631-581-4400
Mailing Address - Fax:516-517-9515
Practice Address - Street 1:15 PARK AVE STE 2
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7381
Practice Address - Country:US
Practice Address - Phone:631-581-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty