Organization · NPI-2

51 John Street Medical PC

Clinic/Center, Ambulatory Surgical · Babylon, NY

NPI number1306142245
StatusActive
Last updated in NPPESJul 22, 2020

Details

NPI
1306142245
Entity type
Organization (NPI-2)
Legal business name
51 John Street Medical PC
Organization subpart
No
Enumeration date
Feb 9, 2011
Certification date
Jul 22, 2020
Last updated
Jul 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA1903X Clinic/Center, Ambulatory Surgical––Yes

Practice location

51 John St Ste 4
Babylon, NY 11702-2928

Phone 631-661-0400 · Fax 631-661-0463

Mailing address

51 John St
Suite 4
Babylon, NY 11702-2928

Phone 631-669-0500 · Fax 631-661-0463

Authorized official

Teresa A Fuller
Office Manager
6316610400

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