Organization
RONKONKOMA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK BARRETT (OWNER)
(631) 472-6000
Entity
Organization
Contact information
Practice address
382 ROSEVALE AVE, RONKONKOMA, NY 11779-3069
(631) 472-6000
Mailing address
382 ROSEVALE AVE, RONKONKOMA, NY 11779-3069
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
07/03/2013
Last updated
08/08/2013
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