1. Home
  2. Directory
  3. New York
  4. Jackson Hts
  5. Psychiatry Neurology
  6. NPI Profile

LEGACY MEDICAL PLLC
NPI 1457609653
Psychiatry & Neurology - Neurology in Jackson Hts, NY

Active since August 17, 2012
3741 77TH ST, JACKSON HTS, NY 11372(718) 406-9588 Get Directions Write a Review

NPPES record last updated: February 25, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Legacy Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY MEDICAL PLLC (NPI 1457609653) is a healthcare organization registered as a neurology in Jackson Hts, New York and active in the NPI registry since August 2012. The organization lists Madhu Boppana, Owner, as its authorized official.

NPPES Registry Identity

NPI1457609653
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameLEGACY MEDICAL PLLC
Location Address3741 77TH STJackson Hts, NY 11372-6629
Mailing Address245 8th Ave # 101New York, NY 10011-1607 · (646) 270-1050
Phone(718) 406-9588
Organization SubpartNo
Authorized OfficialMadhu BoppanaOwner · (646) 270-1050
Enumeration DateAugust 17, 2012
Last NPPES UpdateFebruary 25, 2020
✔ NPI 1457609653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in NY · 199052-1
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
3741 77TH ST, Jackson Hts, NY 11372
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KLS MEDICAL, PC
Clinic/Center (Primary Care)
3741 77TH ST
JACKSON HEIGHTS, NY 11372
Queens County (718) 505-1420
MISS VEENA CHUGH
Physical Therapist
3741 77TH ST
JACKSON HEIGHTS, NY 11372
Queens County (718) 205-1720
CHIU-YING LIU
Acupuncturist
3741 77TH ST
JACKSON HEIGHTS, NY 11372
Queens County (718) 406-9588
DHRUVI PATEL
Physical Therapist
3741 77TH ST
JACKSON HEIGHTS, NY 11372
Queens County (718) 406-9588
LIFE TARGET PT, P.C.
Physical Therapist
3741 77TH ST
FLUSHING, NY 11372
Queens County (347) 401-8390
ROKEYA HABIB M.D.
Specialist
3741 77TH ST, 1ST FLOOR
JACKSON HEIGHTS, NY 11372
Queens County (631) 332-0694

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Medical PLLC's NPI number?

The NPI number for Legacy Medical PLLC is 1457609653. It was assigned to this organization in the NPPES registry on August 17, 2012.

Where is Legacy Medical PLLC located?

Legacy Medical PLLC is located at 3741 77th St, Jackson Hts, NY 11372. The listed phone number is (718) 406-9588.

What is Legacy Medical PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

When was this NPI record last updated?

The NPPES record for Legacy Medical PLLC was last updated on February 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.