| Icarern | |
|
202 W Yaphank Rd Coram NY 11727-4073 | |
| (631) 933-8897 | |
| Not Available |
| Full Name | Icarern |
|---|---|
| Speciality | General Practice |
| Location | 202 W Yaphank Rd, Coram, New York |
| Authorized Official Name and Position | Natasha Jackson (CNO) |
| Authorized Official Contact | 6319338897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icarern 202 W Yaphank Rd Coram NY 11727-4073 Ph: (631) 933-8897 | Icarern 202 W Yaphank Rd Coram NY 11727-4073 Ph: (631) 933-8897 |
| NPI Number | 1841992492 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 03/20/2023 |
| Certification Date | 03/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841992492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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