Organization
RIVERHEAD SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HESHAM MAHMOUD ATWA M.D. (OWNER)
(631) 476-9296
Entity
Organization
Contact information
Practice address
4 TECHNOLOGY DRIVE, SUITE 220, EAST SETAUKET, NY 11733-4085
(631) 476-9296
(631) 476-9298
Mailing address
4 TECHNOLOGY DRIVE, SUITE 220, EAST SETAUKET, NY 11733-4085
(631) 476-9296
(631) 476-9298
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/20/2019
Last updated
10/10/2019
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