Organization
DESTINO MEDICAL DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALVATORE TRAZZERA M.D. (PRESIDENT)
(516) 834-9380
Entity
Organization
Contact information
Practice address
202 FALLWOOD PKWY, FARMINGDALE, NY 11735-4929
(631) 834-9380
Mailing address
202 FALLWOOD PKWY, FARMINGDALE, NY 11735-4929
(631) 834-9380
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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