Organization
MOLLICK ETRA ETRA & COHEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD G. ETRA M.D. (M.D.)
(516) 487-6200
Entity
Organization
Contact information
Practice address
560 NORTHERN BLVD, SUITE 204, GREAT NECK, NY 11021-5100
(516) 487-6200
(516) 487-6329
Mailing address
560 NORTHERN BLVD, SUITE 204, GREAT NECK, NY 11021-5100
(516) 487-6200
(516) 487-6329
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
215924
NY
207ND0101X
MOHS-Micrographic Surgery Physician
217820
NY
207Y00000X
Otolaryngology Physician
125573
NY
207Y00000X
Otolaryngology Physician
127393
NY
207Y00000X
Otolaryngology Physician
Primary
128003
NY
207YS0123X
Facial Plastic Surgery Physician
207896
NY
Other
Enumeration date
10/18/2006
Last updated
12/18/2009
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