| Ageless 360 Medical Group | |
|
694 Motor Pkwy Suite 101 Hauppauge NY 11788-5175 | |
| (631) 265-9355 | |
| (631) 864-8504 |
| Full Name | Ageless 360 Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 694 Motor Pkwy, Hauppauge, New York |
| Authorized Official Name and Position | Roxanne G Carfora (PHYSICIAN/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6312659355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless 360 Medical Group 694 Motor Pkwy Suite 101 Hauppauge NY 11788-5175 Ph: (631) 265-9355 | Ageless 360 Medical Group 694 Motor Pkwy Suite 101 Hauppauge NY 11788-5175 Ph: (631) 265-9355 |
| NPI Number | 1962830851 |
|---|---|
| Provider Enumeration Date | 10/31/2013 |
| Last Update Date | 04/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962830851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 186098 (New York) | Primary |
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