Organization
UNITED COMPREHENSIVE CARE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUS MANTIA MD (OWNER)
(631) 208-4460
Entity
Organization
Contact information
Practice address
170 OLD COUNTRY RD, RIVERHEAD, NY 11901
(631) 208-4460
Mailing address
170 OLD COUNTRY RD, RIVERHEAD, NY 11901
(631) 208-4460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
124142
NY
213E00000X
Podiatrist
Primary
005442
NY
Other
Enumeration date
05/01/2007
Last updated
02/24/2010
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