Prospect Medical Group

NPI #1114198504 in Syosset, New York

Provider Information

NPI Number: 1114198504
Entity Type: Organization
Organization Name: Prospect Medical Group
Primary Specialty: Specialist
Enumeration Date: Mar 13, 2008
Last Updated: Mar 24, 2008

Practice Location

Address: 15 WOODCREST DR
City: Syosset
State: New York
ZIP Code: 11791-3036
Phone: (718) 613-4442

Authorized Official

Name: MR. DARIN DUNN
Title: PRACTICE MANAGER
Phone: (718) 613-4442

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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