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General NPI Number Information
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NPI Number | 1609936228
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Entity Type | Organization
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Legal Business Name | FINK FAMILY MEDICAL P.C
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 152 ISLIP AVE SUITE 22
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City | ISLIP
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State | NY
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Zip | 11751-3225
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Country | US
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Telephone | 631-277-1692
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Fax | 631-277-1804
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Provider Business Mailing Address
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Address Line | 152 ISLIP AVE SUITE 22
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City | ISLIP
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State | NY
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Zip | 11751-3225
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Country | US
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Telephone | 631-277-1692
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Fax | 631-277-1804
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LEO P FINK
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Credential | D.O.
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Telephone | 631-277-1692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 198967
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License Number State | NY
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