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Organization
THREE VILLAGE MEDICAL, PC
Active
Organization
THREE VILLAGE MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW J VISO DC (MANAGER)
(631) 751-5588
Entity
Organization
Contact information
Practice address
207 HALLOCK RD, SUITE 160, STONY BROOK, NY 11790-3033
(631) 751-5588
(631) 751-5821
Mailing address
1890 NEW YORK AVE, HUNTINGTON STATION, NY 11746-2904
(631) 427-6920
(631) 425-0653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
103139
NY
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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