Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

300 Old Country Road Medical PLLC

Organization Obstetrics & Gynecology Physician · NPI 1164935276

300 Old Country Road Medical PLLC is an Obstetrics & Gynecology Physician in Mineola, New York. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Old Country Rd Ste 201
Mineola, NY 11501-4199
Phone: (516) 702-4924
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X

Record details

NPI number1164935276
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lawrence Tydings — Medical Director · (516) 702-4924
NPI enumeratedNovember 10, 2017
Last updated in NPPESNovember 10, 2017
Mailing address1231 Moores Hill Rd, Syosset, NY 11791-9631

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