Organization
FAMILY MEDICAL PRACTICE OF LONG ISLAND P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT POLOFSKY D.O. (OWNER)
(631) 786-5692
Entity
Organization
Contact information
Practice address
221 BROADWAY, SUITE 207, AMITYVILLE, NY 11701-2780
(631) 786-5692
(631) 368-4891
Mailing address
PO BOX 230, MASSAPEQUA, NY 11758-0230
(631) 786-5692
(631) 368-4891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
168859
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01558938
—
NY
01
—
0490232
AETNA
NY
01
—
062449890
GREAT WEST
NY
01
—
080142404
MEDICARE RRB
NY
01
—
168859
HIP
NY
01
—
168859-A10
HEALTHFIRST
NY
01
—
21003100852
BEECH STREET
NY
01
—
2849737
CIGNA
NY
01
—
2C8087
HEALTHNET
NY
01
—
50767
VYTRA
NY
01
—
6004917
GHI
NY
01
—
97F471
BLUE CROSS BLUE SHIELD
NY
01
—
DA48747A
MDNY
NY
01
—
P398100
OXFORD
NY
Enumeration date
11/22/2006
Last updated
03/16/2017
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