| House Md | |
|
5018 Express Dr S Ronkonkoma NY 11779-5589 | |
| (833) 266-7171 | |
| (631) 209-5129 |
| Full Name | House Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 5018 Express Dr S, Ronkonkoma, New York |
| Authorized Official Name and Position | Sunil Sharma (OWNER/ PHYSICIAN) |
| Authorized Official Contact | 8332667171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| House Md 5018 Express Dr S Ronkonkoma NY 11779-5589 Ph: (833) 266-7171 | House Md 5018 Express Dr S Ronkonkoma NY 11779-5589 Ph: (833) 266-7171 |
| NPI Number | 1134768591 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 12/07/2022 |
| Medicare PECOS PAC ID | 2163859810 |
|---|---|
| Medicare Enrollment ID | O20200219001727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134768591 | NPI | - | NPPES |
| Provider Name | Kristy M Raio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225374333 PECOS PAC ID: 2769602135 Enrollment ID: I20230111002044 |
| Provider Name | Sunil Sharma |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881614915 PECOS PAC ID: 0648321455 Enrollment ID: I20230119002698 |
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