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1556 Straight Path Wyandanch NY 11798-3213 | |
(631) 854-1700 | |
(631) 854-1783 |
Full Name | |
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Speciality | Clinic/center |
Location | 1556 Straight Path, Wyandanch, New York |
Authorized Official Name and Position | James L Tomarken (COMMISSIONER) |
Authorized Official Contact | 6318540100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3500 Sunrise Hwy, Suite 124 P.o. Box 9006 Great River NY 11739-9006 Ph: (631) 854-0000 | 1556 Straight Path Wyandanch NY 11798-3213 Ph: (631) 854-1700 |
NPI Number | 1275637480 |
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Provider Enumeration Date | 09/08/2006 |
Last Update Date | 10/17/2012 |
Identifier | Type | State | Issuer |
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1275637480 | NPI | - | NPPES |
03003601 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Skope Medical Care P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1537 Straight Path, Ste 102, Wyandanch, NY 11798 Phone: 631-253-0270 |