Organization
LARRY HAM OB-GYN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN VAVAS (CREDENTIALS)
(516) 255-1616
Entity
Organization
Contact information
Practice address
176 N VILLAGE AVE, SITE 1C, ROCKVILLE CENTRE, NY 11570-3800
(516) 594-1068
Mailing address
176 N VILLAGE AVE, SITE 1C, ROCKVILLE CENTRE, NY 11570-3800
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
213395
NY
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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