Organization
PECONIC BAY MEDICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KUBIAK MD (MEDICAL DIRECTOR)
(631) 548-6470
Entity
Organization
Contact information
Practice address
496 COUNTY ROAD 111, BUILDING F, MANORVILLE, NY 11949-3383
(631) 405-3200
Mailing address
185 OLD COUNTRY RD, SUITE 2, RIVERHEAD, NY 11901-2121
(631) 298-4479
(631) 591-3047
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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