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880 N Broadway Massapequa NY 11758-2351 | |
| (516) 541-0300 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 880 N Broadway, Massapequa, New York |
| Authorized Official Name and Position | Philip D. Ragno (CO-PRESIDENT) |
| Authorized Official Contact | 5168772626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
700 Hicksville Rd Suite 204 Bethpage NY 11714-3471 Ph: () - | 880 N Broadway Massapequa NY 11758-2351 Ph: (516) 541-0300 |
| NPI Number | 1972969111 |
|---|---|
| Provider Enumeration Date | 01/04/2016 |
| Last Update Date | 01/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972969111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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