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Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD LESLIE COVEN (PRESIDENT)
(631) 264-2788
Entity
Organization

Contact information

Practice address
56 GRAND CENTRAL AVE, AMITYVILLE, NY 11701-3749
(631) 264-2788
Mailing address
56 GRAND CENTRAL AVE, AMITYVILLE, NY 11701-3749

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
136115
NY

Other

Enumeration date
03/13/2018
Last updated
03/13/2018
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