Organization
MARINA I PEREDO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARINA I PEREDO MD PC (OWNER PRESIDENT)
(631) 863-3221
Entity
Organization
Contact information
Practice address
260 MIDDLE COUNTRY RD, STE 208, SMITHTOWN, NY 11787
(631) 863-3223
(631) 863-3334
Mailing address
260 MIDDLE COUNTRY RD, STE 208, SMITHTOWN, NY 11787
(631) 863-3223
(631) 863-3334
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
190716
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01836915
—
NY
Enumeration date
03/08/2006
Last updated
07/10/2008
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