Provider First Line Business Practice Location Address:
1000 MONTAUK HIGHWAY
Provider Second Line Business Practice Location Address:
GOOD SAMARITAN HOSPITAL
Provider Business Practice Location Address City Name:
WEST ISLIP
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-595-1100
Provider Business Practice Location Address Fax Number:
612-294-4903
Provider Enumeration Date:
03/09/2006