Healthcare Provider Details

I. General information

NPI: 1487691481
Provider Name (Legal Business Name): WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MINEOLA BLVD SUITE 100
MINEOLA NY
11501
US

IV. Provider business mailing address

120 MINEOLA BLVD SUITE 100
MINEOLA NY
11501
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-3010
  • Fax: 516-663-3026
Mailing address:
  • Phone: 516-663-3010
  • Fax: 516-663-3026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH GRECO
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 516-663-8209