| Great South Bay Medical Practice | |
|
213 Montauk Hwy West Sayville NY 11796-1800 | |
| (631) 563-6205 | |
| (631) 563-7718 |
| Full Name | Great South Bay Medical Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 213 Montauk Hwy, West Sayville, New York |
| Authorized Official Name and Position | Jack Soterakis (PRESIDENT) |
| Authorized Official Contact | 5165626231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great South Bay Medical Practice Po Box 95000-6625 Philadelphia PA 19195-6625 Ph: (631) 465-6297 | Great South Bay Medical Practice 213 Montauk Hwy West Sayville NY 11796-1800 Ph: (631) 563-6205 |
| NPI Number | 1679823512 |
|---|---|
| Provider Enumeration Date | 09/19/2012 |
| Last Update Date | 07/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679823512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Great South Bay Family Medical Practice Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Montauk Hwy, West Sayville, NY 11796 Phone: 631-563-6205 Fax: 631-563-7718 |