Organization
FARMINGDALE ENDOSCOPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD CURTIS FAGAN MD (PRESIDENT)
(631) 752-7000
Entity
Organization
Contact information
Practice address
1111 ROUTE 110, SUITE 205, EAST FARMINGDALE, NY 11735
(631) 752-7000
(631) 752-3602
Mailing address
1943 VINCENT LANE, MUTTONTOWN, NY 11791
(631) 752-7000
(631) 752-7025
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
17831
NY
Other
Enumeration date
02/25/2010
Last updated
02/25/2010
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