Organization
EPIC MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISE Y GUADARRAMA PA (PRESIDENT/OWNER)
(631) 526-9305
Entity
Organization
Contact information
Practice address
145 ORINOCO DR, SUITE 614, BRIGHTWATERS, NY 11718-3024
(631) 526-9305
(631) 526-9306
Mailing address
PO BOX 614, BRIGHTWATERS, NY 11718-0614
(631) 526-9305
(631) 526-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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