Organization
MONTAUK MEDICAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD ROUSSEAU MD (MEMBER)
(833) 547-7463
Entity
Organization
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(833) 547-7463
(631) 248-5583
Mailing address
PO BOX 459, WEST ISLIP, NY 11795-0459
(833) 547-7463
(631) 248-5583
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
03/09/2023
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