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Organization
STATE STREET MEDICAL PLLC
Active
Organization
STATE STREET MEDICAL PLLC
Active
Other names
Medical Trigger Point
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LITVAK (OWNER)
(516) 851-6087
Entity
Organization
Contact information
Practice address
555 N COUNTRY RD, SAINT JAMES, NY 11780-1444
(631) 862-1737
Mailing address
85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
(516) 851-6087
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
12/08/2022
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