Organization
TOP TIER MEDICAL BREAST SPECIALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA M FORTE (DIRECTOR OF CONTRACTING)
(631) 930-9422
Entity
Organization
Contact information
Practice address
150 E SUNRISE HWY, 208, LINDENHURST, NY 11757-2598
(631) 870-8721
(631) 870-8722
Mailing address
150 E SUNRISE HWY, 208, LINDENHURST, NY 11757-2598
(631) 870-8721
(631) 870-8722
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
235438
NY
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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