| South Ocean Care Llc | |
|
101 S Bergen Pl Freeport NY 11520-3528 | |
| (516) 623-3600 | |
| (516) 623-9191 |
| Full Name | South Ocean Care Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 101 S Bergen Pl, Freeport, New York |
| Authorized Official Name and Position | Mark A Raifman (MANAGING MEMBER) |
| Authorized Official Contact | 5166233600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Ocean Care Llc Po Box 624 Woodmere NY 11598-0624 Ph: (516) 623-3600 | South Ocean Care Llc 101 S Bergen Pl Freeport NY 11520-3528 Ph: (516) 623-3600 |
| NPI Number | 1205811049 |
|---|---|
| Provider Enumeration Date | 12/14/2005 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205811049 | NPI | - | NPPES |
| 02289783 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2904201R (New York) | Primary |
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Luis O Herrera Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 43 Church St, Freeport, NY 11520 Phone: 516-223-2900 Fax: 516-223-7320 | |
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