Organization
MANTIA MEDICAL ASSOCIATES
Active
Other names
496 Nesconset Hwy Suite 200 Smithtown NY 11787
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTUS MANTIA (MD)
(631) 265-9111
Entity
Organization
Contact information
Practice address
496 NESCONSET HIGHWAY, STE 200, SMITHTOWN, NY 11787
(631) 265-9111
Mailing address
496 NESCONSET HIGHWAY, STE 200, SMITHTOWN, NY 11787
(631) 265-9111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
182606
NY
207R00000X
Internal Medicine Physician
094617
NY
207R00000X
Internal Medicine Physician
124142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155862
—
NY
05
—
1577013
—
NY
05
—
2785973
—
NY
Enumeration date
11/28/2006
Last updated
09/11/2025
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