Marie T Pottanat, MD

NPI #1114966306 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1114966306
Entity Type: Individual
Name: Marie T Pottanat, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Jun 5, 2006
Last Updated: Oct 8, 2011

Practice Location

Address: 640 HAWKINS AVE
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-2324
Phone: (631) 737-0100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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