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General NPI Number Information
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NPI Number | 1578934071
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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 | 10/12/2015
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 1279 E MAIN ST
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City | RIVERHEAD
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State | NY
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Zip | 11901-2583
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Country | US
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Telephone | 631-727-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 700 HICKSVILLE RD SUITE 204
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City | BETHPAGE
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State | NY
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Zip | 11714-3471
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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 | CO-PRESIDENT
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Name | PHILIP D RAGNO
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Credential | MD
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Telephone | 516-877-2629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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