Keith G Ancona, MD | |
300 E Main St, Suite 5, Smithtown, NY 11787-2900 | |
(631) 979-6466 | |
(631) 979-6475 |
Full Name | Keith G Ancona |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 300 E Main St, Smithtown, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619934205 | NPI | - | NPPES |
02413734 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 221658 (New York) | Primary |
Entity Name | Boston Children's Health Physicians Llp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467454967 PECOS PAC ID: 8325937014 Enrollment ID: O20040311000864 |
Mailing Address | Practice Location Address |
---|---|
Keith G Ancona, MD 300 E Main St, Suite 5, Smithtown, NY 11787-2900 Ph: (631) 979-6466 | Keith G Ancona, MD 300 E Main St, Suite 5, Smithtown, NY 11787-2900 Ph: (631) 979-6466 |
Dr. Nubia Stella Vargas-chen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 260 E Middle Country Rd, Smithtown, NY 11787 Phone: 631-979-7222 | |
Dr. Daniel Mayer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 263 East Main Street, Smithtown, NY 11787 Phone: 631-366-5252 | |
Dr. Mary Ann Flynn Gameng, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 E Main St, Suite 5, Smithtown, NY 11787 Phone: 631-979-6466 Fax: 631-979-6475 | |
Richard C Ancona, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 E Main St, Suite 5, Smithtown, NY 11787 Phone: 631-979-6466 Fax: 631-979-6475 | |
Michael Robert Stern, MD, FAAP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 E Main St, Suite 5, Smithtown, NY 11787 Phone: 631-979-6466 Fax: 631-979-6475 | |
Dr. Suzette Umbao Santos, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 260 E Middle Country Rd Ste 107, Smithtown, NY 11787 Phone: 631-979-7222 | |
Dr. Samina B Bhatty, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 50 Route 25a, Smithtown, NY 11787 Phone: 631-862-3250 |