Provider First Line Business Practice Location Address:
158 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
OCEAN FAMILY MEDICINE
Provider Business Practice Location Address City Name:
BAY SHORE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-665-5634
Provider Business Practice Location Address Fax Number:
631-665-5639
Provider Enumeration Date:
11/18/2005