Organization
IMAM MEDICAL PC
Active
Other names
The CIIT Center of Center Moriches
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WEITZBERG (BUSINESS MANAGER)
(516) 243-8660
Entity
Organization
Contact information
Practice address
2 UNION AVE, CENTER MORICHES, NY 11934-3324
(631) 645-3613
Mailing address
131 SUNNYSIDE BLVD STE 100, PLAINVIEW, NY 11803-1539
(516) 243-8660
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
159557-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144394826
—
NY
Enumeration date
01/23/2017
Last updated
02/21/2017
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