Organization
STATE STREET MEDICAL PLLC
Active
Other names
Medical Trigger Point
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LITVAK (OWNER)
(516) 851-6087
Entity
Organization
Contact information
Practice address
555 N COUNTRY RD, SAINT JAMES, NY 11780-1444
(631) 862-1737
Mailing address
85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
(516) 851-6087
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
12/08/2022
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