Community Medical Care of Centereach, P.c.

NPI #1396140612 in Centereach, New York

Provider Information

NPI Number: 1396140612
Entity Type: Organization
Organization Name: Community Medical Care of Centereach, P.c.
Primary Specialty: Emergency Medicine
Enumeration Date: Oct 29, 2014
Last Updated: Oct 29, 2014

Practice Location

Address: 2134 MIDDLE COUNTRY RD
City: Centereach
State: New York
ZIP Code: 11720-3519
Phone: (631) 588-0550

Authorized Official

Name: MRS. LEA LACSAMANA TALA, MD
Title: OWNER
Phone: (631) 588-0550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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