Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
May 2, 2016
License(s)
P106558 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 150 EILEEN WAY UNIT 1 | Syosset, NY 11791-5313 | 516-855-5255 |
| MAILING | 111 CENTRAL AVE SAINT MICHAEL MEDICAL CENTER, MEDICAL EDUCATION BUILDIN | Newark, NJ 07102-1909 | 973-877-5000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.