Individual
MR. CARLOS ALBERTO CONCEPCION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1377 5TH AVE, BAY SHORE, NY 11706-4131
(631) 647-3265
Mailing address
111 CLIFF RD, PORT JEFFERSON, NY 11777-1252
(631) 235-4185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004769
NY
Other
Enumeration date
10/01/2008
Last updated
08/05/2015
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