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Organization
MIDDLE COUNTRY FAMILY MEDICINE P C
Active
Organization
MIDDLE COUNTRY FAMILY MEDICINE P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L. RANDALL D.O. (PRESIDENT)
(631) 580-1740
Entity
Organization
Contact information
Practice address
2539 MIDDLE COUNTRY RD, SUITE 5, CENTEREACH, NY 11720-3551
(631) 580-1740
(631) 580-1955
Mailing address
2539 MIDDLE COUNTRY RD, SUITE 5, CENTEREACH, NY 11720-3551
(631) 580-1740
(631) 580-1955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200458
NY
Other
Enumeration date
03/17/2008
Last updated
03/24/2014
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