Individual
DR. IRA REZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
PO BOX 660, STONY BROOK, NY 11790-0660
(631) 689-8574
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
92715
NY
Other
Enumeration date
02/21/2006
Last updated
07/08/2007
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