| Mattituck Family Medicine Pllc | |
|
7555 Main Rd Mattituck NY 11952-1516 | |
| (631) 298-1678 | |
| (631) 298-1679 |
| Full Name | Mattituck Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 7555 Main Rd, Mattituck, New York |
| Authorized Official Name and Position | Cynthia Carlson (OWNER) |
| Authorized Official Contact | 6312981678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mattituck Family Medicine Pllc Po Box 111 Mattituck NY 11952-0111 Ph: (631) 298-1678 | Mattituck Family Medicine Pllc 7555 Main Rd Mattituck NY 11952-1516 Ph: (631) 298-1678 |
| NPI Number | 1538349949 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538349949 | NPI | - | NPPES |
| 01693365 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 199364 (New York) | Primary |
Same Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13400 Main Rd, Mattituck, NY 11952 Phone: 631-298-4008 Fax: 631-298-5969 |