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

Legacy Medical PLLC

Organization Neurology Physician · NPI 1457609653

Legacy Medical PLLC is a Neurology Physician in Jackson Hts, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3741 77th St
Jackson Hts, NY 11372-6629
Phone: (718) 406-9588
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 199052-1 (NY)

Record details

NPI number1457609653
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Madhu Boppana — Owner · (646) 270-1050
NPI enumeratedAugust 17, 2012
Last updated in NPPESFebruary 25, 2020
Certification dateFebruary 25, 2020
Mailing address245 8th Ave # 101, New York, NY 10011-1607