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440 Montauk Highway West Islip NY 11795 | |
(631) 422-4000 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 440 Montauk Highway, West Islip, New York |
Authorized Official Name and Position | Hiro Soriano (CIO) |
Authorized Official Contact | 6314224000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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593 Merrick Rd Lynbrook NY 11563-2349 Ph: (631) 422-4000 | 440 Montauk Highway West Islip NY 11795 Ph: (631) 422-4000 |
NPI Number | 1841656030 |
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Provider Enumeration Date | 01/05/2016 |
Last Update Date | 12/07/2016 |
Identifier | Type | State | Issuer |
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1841656030 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 038460 (New York) | Primary |
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