| Island Medical House Doctor Pc | |
|
88 Arkay Dr Hauppauge NY 11788-3757 | |
| (631) 514-7600 | |
| (631) 514-7601 |
| Full Name | Island Medical House Doctor Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 88 Arkay Dr, Hauppauge, New York |
| Authorized Official Name and Position | Daniel Ralph Ferrara (PRESIDENT) |
| Authorized Official Contact | 6315147600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Medical House Doctor Pc 88 Arkay Dr Hauppauge NY 11788-3757 Ph: (631) 514-7600 | Island Medical House Doctor Pc 88 Arkay Dr Hauppauge NY 11788-3757 Ph: (631) 514-7600 |
| NPI Number | 1477704005 |
|---|---|
| Provider Enumeration Date | 10/01/2008 |
| Last Update Date | 10/01/2008 |
| Medicare PECOS PAC ID | 8921162801 |
|---|---|
| Medicare Enrollment ID | O20090127000575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477704005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | NY170935 (New York) | Primary |
| Provider Name | Lawrence Salob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225053580 PECOS PAC ID: 5092776245 Enrollment ID: I20041021000685 |
| Provider Name | Linda Citro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841277050 PECOS PAC ID: 9436196144 Enrollment ID: I20050414000343 |
| Provider Name | Gayle Couleas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093722951 PECOS PAC ID: 5496765877 Enrollment ID: I20060429000016 |
| Provider Name | Marie Florence Celestin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316192552 PECOS PAC ID: 9739356528 Enrollment ID: I20120119000174 |
| Provider Name | Nicoleta V Koschack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780051482 PECOS PAC ID: 3476832114 Enrollment ID: I20161121000368 |
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