Registry details
Type
Organization
Primary specialty
Family Medicine
Enumerated
Jul 16, 2010
License(s)
214856-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 12507 LIBERTY AVE | South Richmond Hill, NY 11419-2233 | 718-845-8900 |
| LOCATION | 12507 LIBERTY AVE | South Richmond Hill, NY 11419-2233 | 718-845-8900 |
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.