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Organization

HOLBROOK INTERNAL MEDICINE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL JOSPEH LAIETA D.O., F.A.C.P. (PRESIDENT/CEO)
(631) 960-5945
Entity
Organization

Contact information

Practice address
900 MAIN ST, HOLBROOK, NY 11741-1623
(631) 960-5945
Mailing address
PO BOX 82, WADING RIVER, NY 11792-0082
(631) 960-5945

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
230975
NY

Other

Enumeration date
02/25/2010
Last updated
02/25/2010
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