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Organization
RONALD C FAGAN MD PC
Active
Organization
RONALD C FAGAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS NICOSIA (OFFICE MANAGER)
(631) 752-7000
Entity
Organization
Contact information
Practice address
254-41 HORACE HARDING EXPWY, LITTLE NECK, NY 11362
(718) 224-4100
(718) 224-4527
Mailing address
1111 BROADHOLLOW RD, FARMINGDALE, NY 11735-4820
(631) 752-7000
(631) 752-7025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
227578
NY
Other
Enumeration date
12/13/2006
Last updated
01/11/2008
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