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Organization
FIVE BOROUGHS MEDICAL ASSOCIATES, P.C.
Active
Organization
FIVE BOROUGHS MEDICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MARMOR (ADMINISTRATOR)
(718) 629-5590
Entity
Organization
Contact information
Practice address
36 OSPREY AVENUE, RIVERHEAD, NY 11901
(347) 417-9081
Mailing address
PO BOX 158, PLAINVIEW, NY 11803
(347) 417-9081
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
255627
NY
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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