Organization
PROSPECT STREET OBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN SCHULLER M.D. (MEDICAL DIRECTOR)
(631) 421-0020
Entity
Organization
Contact information
Practice address
200 W CARVER ST, SUITE 1, HUNTINGTON, NY 11743-3303
(631) 421-0020
Mailing address
200 W CARVER ST, SUITE 1, HUNTINGTON, NY 11743-3303
(631) 421-0020
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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