Healthcare Provider Details
I. General information
NPI: 1326232950
Provider Name (Legal Business Name): SOUND MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2007
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
516 MONTAUK HWY SUITE 1
EAST MORICHES NY
11940-1225
US
IV. Provider business mailing address
516 MONTAUK HWY SUITE 1
EAST MORICHES NY
11940-1225
US
V. Phone/Fax
- Phone: 631-874-2900
- Fax: 631-874-2948
- Phone: 631-874-2900
- Fax: 631-874-2948
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
CELENTANO
Title or Position: DIRECTOR
Credential: M.D.
Phone: 631-874-2900