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1717 MEDICAL PC
NPI 1467134684
Physical Medicine & Rehabilitation - Sports Medicine in Islandia, NY

Active since August 07, 2023
1717 VETERANS MEMORIAL HWY STE 1, ISLANDIA, NY 11749(631) 203-4300 Get Directions Write a Review

NPPES record last updated: August 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 1717 Medical Pc NPPES

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

1717 MEDICAL PC (NPI 1467134684) is a healthcare organization registered as a sports medicine in Islandia, New York and active in the NPI registry since August 2023. The organization lists Jordan Sudberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1467134684
Entity TypeOrganization
Primary Taxonomy2081S0010X
Legal Business Name1717 MEDICAL PC
Location Address1717 VETERANS MEMORIAL HWY STE 1Islandia, NY 11749-1532
Mailing Address1717 Veterans Memorial Hwy Ste 1Islandia, NY 11749-1532
Phone(631) 203-4300
Organization SubpartNo
Authorized OfficialJordan SudbergOwner · (631) 482-2754
Enumeration DateAugust 7, 2023
NPPES CertifiedAugust 7, 2023
✔ NPI 1467134684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081S0010X
Definition

A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

1717 VETERANS MEMORIAL HWY STE 1, Islandia, NY 11749
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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 4

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

DR. JORDAN SUDBERG M.D
Physical Medicine & Rehabilitation (Sports Medicine)
1717 VETERANS MEMORIAL HWY STE 1
ISLANDIA, NY 11749
Suffolk County (631) 203-4300
MID-SUFFOLK CHIROPRACTIC P.C.
Chiropractor
1717 VETERANS MEMORIAL HWY STE 1
ISLANDIA, NY 11749
Suffolk County (631) 203-4300
JORDAN SUDBERG MD P.C.
Physical Medicine & Rehabilitation (Pain Medicine)
1717 VETERANS MEMORIAL HWY STE 1
ISLANDIA, NY 11749
Suffolk County (646) 239-8418
ALISON DE LOS SANTOS
Massage Therapist
1717 VETERANS MEMORIAL HWY STE 1
ISLANDIA, NY 11749
Suffolk County (631) 203-4300

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 1717 Medical PC's NPI number?

The NPI number for 1717 Medical PC is 1467134684. It was assigned to this organization in the NPPES registry on August 7, 2023.

Where is 1717 Medical PC located?

1717 Medical PC is located at 1717 Veterans Memorial Hwy Ste 1, Islandia, NY 11749. The listed phone number is (631) 203-4300.

What is 1717 Medical PC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

When was this NPI record last updated?

The NPPES record for 1717 Medical PC was last updated on August 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.