| Cherese M. Laporta D.o., Pllc | |
|
107 N Ocean Ave Suite G Patchogue NY 11772-2012 | |
| (631) 654-5004 | |
| (631) 654-5048 |
| Full Name | Cherese M. Laporta D.o., Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 N Ocean Ave, Patchogue, New York |
| Authorized Official Name and Position | Vera Kruta (BILLER) |
| Authorized Official Contact | 6316545004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherese M. Laporta D.o., Pllc 107 N Ocean Ave Suite G Patchogue NY 11772-2012 Ph: (631) 654-5004 | Cherese M. Laporta D.o., Pllc 107 N Ocean Ave Suite G Patchogue NY 11772-2012 Ph: (631) 654-5004 |
| NPI Number | 1700050051 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Medicare PECOS PAC ID | 3173412657 |
|---|---|
| Medicare Enrollment ID | O20110328000814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700050051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 184780 (New York) | Primary |
| Provider Name | Cherese M Laporta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437206943 PECOS PAC ID: 7517990492 Enrollment ID: I20050912000868 |
| Provider Name | Vanessa L Petoello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992251631 PECOS PAC ID: 4981985496 Enrollment ID: I20161221000635 |
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