Organization
BRENTWOOD MEDICAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW J VISO DC (MANAGER)
(631) 751-5588
Entity
Organization
Contact information
Practice address
55 SECOND AVE, SUITE 1, BRENTWOOD, NY 11717-4611
(631) 751-5588
Mailing address
1890 NEW YORK AVE, HUNTINGTON STATION, NY 11746-2904
(631) 427-6920
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
183817
NY
Other
Enumeration date
12/27/2006
Last updated
10/29/2010
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