Organization
LIWSM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW JAMES (BILLING MANAGER)
(631) 827-8159
Entity
Organization
Contact information
Practice address
257 E JERICHO TPKE, HUNTINGTON STATION, NY 11746-7338
(631) 827-8159
Mailing address
257 E JERICHO TPKE, HUNTINGTON STATION, NY 11746-7338
(631) 827-8159
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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