Organization
MOMS OB-GYN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANA FARLEY DELEGATED OFFICIAL (ADMINISTRATOR)
(516) 424-7919
Entity
Organization
Contact information
Practice address
120 BETHPAGE RD, HICKSVILLE, NY 11801-1515
(516) 513-1004
(516) 390-9600
Mailing address
503 CLEARMEADOW DR, EAST MEADOW, NY 11554-1224
(516) 424-7919
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
236736
NY
Other
Enumeration date
05/01/2018
Last updated
03/11/2020
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