Organization
RED SHIRT MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA DALEY (ACCOUNT EXECUTIVE)
(347) 417-9081
Entity
Organization
Contact information
Practice address
931 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1228
(347) 417-9081
(718) 732-2434
Mailing address
PO BOX 992, PORT JEFFERSON STATION, NY 11776-0845
(347) 417-9081
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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