Healthcare Provider Details

I. General information

NPI: 1619338282
Provider Name (Legal Business Name): WINTHROP COMMUNITY MEDICAL AFFILIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTHERN BLVD 106
GREAT NECK NY
11021-5206
US

IV. Provider business mailing address

700 HICKSVILLE RD 204
BETHPAGE NY
11714-3471
US

V. Phone/Fax

Practice location:
  • Phone: 516-466-4128
  • Fax: 516-482-1822
Mailing address:
  • Phone: 516-576-6106
  • Fax: 516-576-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC S ADLER
Title or Position: CO-PRESIDENT
Credential: MD
Phone: 516-663-3849