| Country Doctors Family Medicine Hauppauge Pc | |
|
7 Lawrence Hill Rd Huntington NY 11743-3143 | |
| (631) 351-8700 | |
| (631) 351-6995 |
| Full Name | Country Doctors Family Medicine Hauppauge Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7 Lawrence Hill Rd, Huntington, New York |
| Authorized Official Name and Position | Charles R. Timson (PRESIDENT) |
| Authorized Official Contact | 6313518700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Doctors Family Medicine Hauppauge Pc 7 Lawrence Hill Rd Huntington NY 11743-3143 Ph: (631) 351-8700 | Country Doctors Family Medicine Hauppauge Pc 7 Lawrence Hill Rd Huntington NY 11743-3143 Ph: (631) 351-8700 |
| NPI Number | 1790815942 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 05/06/2009 |
| Medicare PECOS PAC ID | 7719878891 |
|---|---|
| Medicare Enrollment ID | O20090504000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790815942 | NPI | - | NPPES |
| 02024151 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 165264 (New York) | Primary |
| Provider Name | Charles R Timson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750332821 PECOS PAC ID: 3971597543 Enrollment ID: I20040414001464 |
| Provider Name | Melvin M Fritz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518044031 PECOS PAC ID: 8729043179 Enrollment ID: I20041124000374 |
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