Organization
HUNTINGTON HOSPITAL ASSOCIATION
Active
Other names
Huntington Hospital Bariatric
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FAGAN (CFO/VPF)
(631) 425-4262
Entity
Organization
Contact information
Practice address
224 WALL ST, HUNTINGTON, NY 11743-2186
(631) 351-2024
(631) 351-1581
Mailing address
PO BOX 418204, BOSTON, MA 02241-8204
(516) 883-7100
(516) 883-7474
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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