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Organization
PECONIC SURGICAL GROUP, PC
Active
Organization
PECONIC SURGICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLAW JOSEF GREDYSA M.D. (PRESIDENT)
(631) 369-8539
Entity
Organization
Contact information
Practice address
31 MAIN RD, SUITE 2, RIVERHEAD, NY 11901-1953
(631) 369-8539
(631) 369-5613
Mailing address
31 MAIN RD, SUITE 2, RIVERHEAD, NY 11901-1953
(631) 369-8539
(631) 369-5613
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
175169
NY
Other
Enumeration date
07/31/2007
Last updated
11/14/2007
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