# FAMILY MEDICAL PRACTICE OF LONG ISLAND P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972678183
- **Authorized official:** DR. ROBERT POLOFSKY D.O. (OWNER)
- **Authorized official phone:** (631) 786-5692

## Contact information

- **Practice address:** 221 BROADWAY, SUITE 207, AMITYVILLE, NY 11701-2780
- **Practice address phone:** (631) 786-5692
- **Practice address fax:** (631) 368-4891
- **Mailing address:** PO BOX 230, MASSAPEQUA, NY 11758-0230
- **Mailing address phone:** (631) 786-5692
- **Mailing address fax:** (631) 368-4891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 168859 | NY | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 03/16/2017