Organization
COMMUNITY MEDICAL CARE OF CENTEREACH, P.C.
Active
Other names
Community Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEA LACSAMANA TALA MD (OWNER)
(631) 588-0550
Entity
Organization
Contact information
Practice address
2134 MIDDLE COUNTRY RD, CENTEREACH, NY 11720-3519
(631) 588-0550
(631) 588-0556
Mailing address
2134 MIDDLE COUNTRY RD, CENTEREACH, NY 11720-3519
(631) 588-0550
(631) 588-0556
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
123294
NY
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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