Organization
DOUGHTY AND RYZOVA MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN ANN RUSSO (BILLING MANAGER)
(631) 689-6226
Entity
Organization
Contact information
Practice address
2500 NESCONSET HWY BLDG 14, STONY BROOK, NY 11790-2555
(631) 689-6226
(631) 675-0736
Mailing address
2500 NESCONSET HWY BLDG 14, STONY BROOK, NY 11790-2555
(631) 689-6226
(631) 675-0736
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063649796
NPI
NY
01
—
1407867724
NPI
NY
01
—
1568633956
NPI
NY
Enumeration date
09/13/2016
Last updated
11/16/2022
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