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Organization
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, PC
Active
Organization
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN BRAAT MD (PRESIDENT)
(631) 727-8050
Entity
Organization
Contact information
Practice address
292 SHADE TREE LANE, AQUEBOGUE, NY 11931
(631) 727-8050
(631) 727-8110
Mailing address
292 SHADE TREE LANE, PO BOX 2668, AQUEBOGUE, NY 11931
(631) 727-8050
(631) 727-8110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/24/2007
Last updated
04/24/2008
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