Organization
FRIENDLY MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSANNA TEDESCO (BILLING MANAGER)
(631) 689-6226
Entity
Organization
Contact information
Practice address
207 HALLOCK ROAD, STONY BROOK, NY 11790
(631) 689-6226
(631) 675-0736
Mailing address
207 HALLOCK ROAD, STONY BROOK, NY 11790
(631) 689-6226
(631) 675-0736
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
154768
NY
208000000X
Pediatrics Physician
Primary
248234
NY
208000000X
Pediatrics Physician
462504
NY
208000000X
Pediatrics Physician
60275504
NY
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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