Organization
CRAIG B ORDWAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG BRADFORD ORDWAY M.D. (PRESIDENT)
(631) 897-7229
Entity
Organization
Contact information
Practice address
40 MAIN ST, NORTHPORT, NY 11768-1722
(631) 754-2663
Mailing address
40 MAIN ST, NORTHPORT, NY 11768-1722
(631) 754-2663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
129877-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00-68330
—
NY
Enumeration date
04/29/2011
Last updated
04/29/2011
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