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Individual

LUIS OSCAR HERRERA-ACEVEDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
43 CHURCH ST, FREEPORT, NY 11520-3830
(516) 223-2900
(516) 223-7320
Mailing address
857 CLIFFSIDE AVE, NORTH WOODMERE, NY 11581-3001
(516) 791-5919
(516) 223-7320

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
196850
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01513620046
NY
Enumeration date
11/04/2005
Last updated
02/24/2012
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