Wading River Medical Care Pc | |
5972 Route 25a Wading River NY 11792-2001 | |
(631) 929-0304 | |
Not Available |
Full Name | Wading River Medical Care Pc |
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Speciality | Internal Medicine |
Location | 5972 Route 25a, Wading River, New York |
Authorized Official Name and Position | Robert Bernard (MD) |
Authorized Official Contact | 6319290304 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wading River Medical Care Pc 5972 Route 25a Wading River NY 11792-2001 Ph: () - | Wading River Medical Care Pc 5972 Route 25a Wading River NY 11792-2001 Ph: (631) 929-0304 |
NPI Number | 1568844801 |
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Provider Enumeration Date | 06/23/2015 |
Last Update Date | 07/07/2015 |
Medicare PECOS PAC ID | 1658687090 |
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Medicare Enrollment ID | O20150901000408 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568844801 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Robert Bernard |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023098464 PECOS PAC ID: 4789770611 Enrollment ID: I20071023000514 |
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