Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Apr 13, 2007
License(s)
242570-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 258 MERRICK RD | Oceanside, NY 11572-1427 | 516-766-0345 |
| LOCATION | 258 MERRICK RD | Oceanside, NY 11572-1427 | 516-766-0345 |
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.