Provider First Line Business Practice Location Address:
NORTH COUNTY CLINIC BLDG. 151
Provider Second Line Business Practice Location Address:
725 VETERANS MEMORIAL HIGHWAY
Provider Business Practice Location Address City Name:
HAUPPAUGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11788-6100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-853-6410
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2007