Organization · NPI-2
Montauk Medical Testing Services PC
Pain Medicine, Interventional Pain Medicine · Islandia, NY
NPI number1770169468
StatusActive
Last updated in NPPESMar 22, 2021
Details
- NPI
- 1770169468
- Entity type
- Organization (NPI-2)
- Legal business name
- Montauk Medical Testing Services PC
- Organization subpart
- No
- Enumeration date
- Mar 22, 2021
- Certification date
- Mar 22, 2021
- Last updated
- Mar 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | Yes |
| 207L00000X | Anesthesiology | – | – |
Practice location
1717 Veterans Memorial Hwy Ste 2Islandia, NY 11749-1532
Phone 631-400-3999
Mailing address
1717 Veterans Memorial Hwy Ste 2Islandia, NY 11749-1532
Phone 631-828-0720
Authorized official
George Kakoulides
Owner
6314003999
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