Great Neck Medicine, PC
Clinic/Center in Great Neck, NY. Organization (NPI-2).
NPI number1629479324
StatusActive
Last updated in NPPESSep 12, 2014
Details
- NPI
- 1629479324
- Entity type
- Organization (NPI-2)
- Legal business name
- Great Neck Medicine, PC
- Organization subpart
- No
- Enumeration date
- Sep 12, 2014
- Last updated
- Sep 12, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 260969 | NY | Yes |
Practice location
290 Community DrGreat Neck, NY 11021-5504
Phone 516-487-1902 · Fax 516-487-4156
Mailing address
290 Community DrGreat Neck, NY 11021-5504
Phone 516-487-1902 · Fax 516-487-4156
Authorized official
Marcello Sozio
Ceo
5164871902
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