Organization
AMITYVILLE INTERNAL MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI QUENZER (BILLING SECRETARY)
(631) 264-0924
Entity
Organization
Contact information
Practice address
49 IRELAND PL, AMITYVILLE, NY 11701-2902
(631) 264-0924
(631) 264-3503
Mailing address
49 IRELAND PL, AMITYVILLE, NY 11701-2902
(631) 264-0924
(631) 264-3503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
132857
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00447296
—
NY
01
—
WJ6411
MEDICARE ID
NY
Enumeration date
03/17/2008
Last updated
04/13/2015
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