Provider Demographics
NPI:1225406838
Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Entity Type:Organization
Organization Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Other - Org Name:SOUTH SHORE HEART CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-877-2629
Mailing Address - Street 1:700 HICKSVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3471
Mailing Address - Country:US
Mailing Address - Phone:516-576-5835
Mailing Address - Fax:
Practice Address - Street 1:242 MERRICK RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5254
Practice Address - Country:US
Practice Address - Phone:516-763-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty