| Evolve Physicians, Pc | |
|
5550 Merrick Rd Massapequa NY 11758-6238 | |
| (631) 673-2333 | |
| (631) 673-1314 |
| Full Name | Evolve Physicians, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5550 Merrick Rd, Massapequa, New York |
| Authorized Official Name and Position | Donna Scoca (CREDENTIALING) |
| Authorized Official Contact | 6316733233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Physicians, Pc 5550 Merrick Rd Massapequa NY 11758-6238 Ph: (631) 673-2333 | Evolve Physicians, Pc 5550 Merrick Rd Massapequa NY 11758-6238 Ph: (631) 673-2333 |
| NPI Number | 1144631839 |
|---|---|
| Provider Enumeration Date | 05/15/2014 |
| Last Update Date | 08/24/2023 |
| Medicare PECOS PAC ID | 8628429164 |
|---|---|
| Medicare Enrollment ID | O20240109001293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144631839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Richard S Zito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366555849 PECOS PAC ID: 4789693292 Enrollment ID: I20060411000734 |
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