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General NPI Number Information
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NPI Number | 1386851038
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE & BIOFEEDBACK SERVICES, P.C.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1212 N COUNTRY RD SUITE 4B
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City | STONY BROOK
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State | NY
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Zip | 11790-1919
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Country | US
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Telephone | 631-689-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 N COUNTRY RD SUITE 4B
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City | STONY BROOK
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State | NY
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Zip | 11790-1919
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Country | US
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Telephone | 631-689-1300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN H MARGOLIS
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Credential | M.D.
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Telephone | 631-689-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 151667
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License Number State | NY
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