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General NPI Number Information
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NPI Number | 1245724152
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Entity Type | Organization
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Legal Business Name | WINTHROP COMMUNITY MEDICAL AFFILIATES PC
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 101 MINEOLA BLVD STE 210
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City | MINEOLA
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State | NY
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Zip | 11501-4089
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Country | US
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Telephone | 516-663-3511
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Fax |
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Provider Business Mailing Address
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Address Line | 700 HICKSVILLE RD STE 204
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City | BETHPAGE
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State | NY
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Zip | 11714-3472
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | BRIAN SADOWSKY
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Credential |
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Telephone | 516-663-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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