Organization
COURTYARD AT MCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN OSTROW (CHIEF EXECUTIVE OFFICER)
(516) 277-2055
Entity
Organization
Contact information
Practice address
320 WEST MERRICK RD., FREEPORT, NY 11520
(516) 208-1250
Mailing address
11 MIDDLE NECK RD. SUITE 202, GREATNECK, NY 11021
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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