Organization
SOUTH NASSAU PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BOGEN (CFO)
(516) 632-3965
Entity
Organization
Contact information
Practice address
1 S CENTRAL AVE, VALLEY STREAM, NY 11580-5443
(516) 632-3350
Mailing address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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