Healthsource Medical Services Medford, Pllc

NPI #1821319575 in Medford, New York

Provider Information

NPI Number: 1821319575
Entity Type: Organization
Organization Name: Healthsource Medical Services Medford, Pllc
Primary Specialty: Internal Medicine
Enumeration Date: Jun 17, 2010
Last Updated: Jun 17, 2010

Practice Location

Address: 1743 N OCEAN AVE
City: Medford
State: New York
ZIP Code: 11763-2649
Phone: (631) 758-3100

Authorized Official

Name: DR. JOHN FOLAN, M.D.
Title: PRESIDENT/OWNER
Phone: (631) 435-0110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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