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Organization
THE FAMILY TREE PSYCHIATRIC & MEDICAL SERVICES
Active
Organization
THE FAMILY TREE PSYCHIATRIC & MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DANIEL COLUCCI D.O. (PRESIDENT)
(631) 209-1477
Entity
Organization
Contact information
Practice address
5225 NESCONSET HWY STE 46, PORT JEFFERSON STATION, NY 11776-2060
(631) 209-1477
(631) 744-3246
Mailing address
70 COBBLESTONE DR, SHOREHAM, NY 11786-2359
(631) 209-1477
(631) 744-3246
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
199981
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02916365
—
NY
Enumeration date
11/12/2007
Last updated
11/12/2007
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