Healthcare Provider Details

I. General information

NPI: 1225406838
Provider Name (Legal Business Name): WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 MERRICK RD SUITE 402
ROCKVILLE CENTRE NY
11570-5254
US

IV. Provider business mailing address

700 HICKSVILLE RD SUITE 204
BETHPAGE NY
11714-3471
US

V. Phone/Fax

Practice location:
  • Phone: 516-763-2800
  • Fax:
Mailing address:
  • Phone: 516-576-5835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP D RAGNO
Title or Position: CO-PRESIDENT
Credential: MD
Phone: 516-877-2629