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Organization
TRI COUNTY MEDICAL ASSOCIATE PC
Active
Organization
TRI COUNTY MEDICAL ASSOCIATE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENU S JERATH MD (DOCTOR OWNER)
(845) 434-6333
Entity
Organization
Contact information
Practice address
20 BROADWAY, WOODRIDGE, NY 12789-0546
(845) 434-6333
(845) 434-2346
Mailing address
PO BOX 546, 20 BROADWAY, WOODRIDGE, NY 12789-0546
(845) 434-6333
(845) 434-2346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
153068-2
NY
Other
Enumeration date
12/02/2005
Last updated
09/28/2007
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