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Organization
HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC
Active
Organization
HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN FOLAN M.D. (PRESIDENT/OWNER)
(631) 435-0110
Entity
Organization
Contact information
Practice address
1743 N OCEAN AVE, MEDFORD, NY 11763-2649
(631) 758-3100
(631) 758-3168
Mailing address
3001 EXPRESS DR N, SUITE 200C, ISLANDIA, NY 11749-5301
(631) 435-0110
(631) 435-4583
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
167755
NY
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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