| Patchogue Family Medical Care, Pc | |
|
130 Medford Ave Patchogue NY 11772-1206 | |
| (631) 475-5734 | |
| (631) 758-2568 |
| Full Name | Patchogue Family Medical Care, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 130 Medford Ave, Patchogue, New York |
| Authorized Official Name and Position | Christine M Doucet (OWNER) |
| Authorized Official Contact | 6314755734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patchogue Family Medical Care, Pc 130 Medford Ave Patchogue NY 11772-1206 Ph: (631) 475-5734 | Patchogue Family Medical Care, Pc 130 Medford Ave Patchogue NY 11772-1206 Ph: (631) 475-5734 |
| NPI Number | 1700915113 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 03/22/2011 |
| Medicare PECOS PAC ID | 0648160713 |
|---|---|
| Medicare Enrollment ID | O20101228000923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700915113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 214240 (New York) | Primary |
| Provider Name | Christine Marie Doucet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063596823 PECOS PAC ID: 7517153760 Enrollment ID: I20101130000535 |
| Provider Name | Andrew S Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134387335 PECOS PAC ID: 5395928634 Enrollment ID: I20110324000555 |
| Provider Name | Simone K Guest |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558598177 PECOS PAC ID: 9436301447 Enrollment ID: I20121219000483 |
| Provider Name | Rivkah E Raza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063827384 PECOS PAC ID: 9537427596 Enrollment ID: I20171220001408 |
| Provider Name | Doreen E Amankwah Owusu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922595891 PECOS PAC ID: 5496009912 Enrollment ID: I20210816002814 |
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