Organization
MAIN ST. MED CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN LAIRD (ADMINISTRATOR)
(631) 447-6100
Entity
Organization
Contact information
Practice address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 447-6100
(631) 447-6126
Mailing address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 447-6100
(631) 447-6126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/07/2006
Last updated
03/13/2008
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