Organization
METRO OBA MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL FORMISANO (MANAGER)
(845) 790-2672
Entity
Organization
Contact information
Practice address
15 01 POLLITT DRIVE, UNITE 8B, FAIRLAWN, NJ 07410
(845) 790-2672
Mailing address
2 CATHARINE STREET, PO BOX 550, POUGHKEEPSIE, NY 12602-0550
(845) 790-2672
(845) 790-2613
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
206251
NY
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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