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Organization
TRI STATE MEDICAL ASSOCIATES PC
Active
Organization
TRI STATE MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELA MATRANGA (PRACTICE ADMINISTRATOR)
(718) 629-5590
Entity
Organization
Contact information
Practice address
931 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1228
(631) 331-7200
(631) 642-0245
Mailing address
1987 UTICA AVE, BROOKLYN, NY 11234-3215
(718) 629-5590
(718) 732-2434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
167850
NY
174400000X
Specialist
182338
NY
Other
Enumeration date
03/10/2009
Last updated
04/27/2009
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