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Organization (NPI-2)
Active
Internal Medicine, Geriatric Medicine
Provider Information
- NPI Number
1669975033- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 56 GRAND CENTRAL AVE, AMITYVILLE, NY, 117013749
- Phone
- (631) 264-2788
Specialties & Taxonomies
Internal Medicine, Geriatric Medicine
Primary License: NY #136115
All Addresses
MAILING
56 GRAND CENTRAL AVE
AMITYVILLE, NY, 117013749