Healthcare Provider Details

I. General information

NPI: 1588020465
Provider Name (Legal Business Name): WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 N BROADWAY SUITE 103
MASSAPEQUA NY
11758-2373
US

IV. Provider business mailing address

700 HICKSVILLE RD SUITE 204
BETHPAGE NY
11714-3471
US

V. Phone/Fax

Practice location:
  • Phone: 516-798-0441
  • Fax:
Mailing address:
  • Phone: 516-576-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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