Organization
WELLWOOD MEDICAL ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN KAMATH M.D. (PRESIDENT)
(631) 957-5551
Entity
Organization
Contact information
Practice address
910 ROUTE 109, LINDENHURST, NY 11757-1158
(631) 957-5551
Mailing address
910 ROUTE 109, LINDENHURST, NY 11757-1158
(631) 957-5551
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2116081
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110267437
1199
NY
Enumeration date
06/01/2009
Last updated
06/01/2009
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