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Organization
GREAT NECK MEDICINE PC
Active
Organization
GREAT NECK MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL SURASKY DO (PRESIDENT)
(516) 487-1902
Entity
Organization
Contact information
Practice address
290 COMMUNITY DR, GREAT NECK, NY 11021-5504
(516) 487-1902
(516) 487-4156
Mailing address
290 COMMUNITY DR, GREAT NECK, NY 11021-5504
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
260969
NY
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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