Provider Demographics
NPI:1275832552
Name:FIVE TOWNS MEDICINE, P.C.
Entity Type:Organization
Organization Name:FIVE TOWNS MEDICINE, P.C.
Other - Org Name:FIVE TOWNS MEDICINE AND CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:OSTREICHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-239-0639
Mailing Address - Street 1:123 MAPLE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2240
Mailing Address - Country:US
Mailing Address - Phone:516-374-6363
Mailing Address - Fax:516-374-6300
Practice Address - Street 1:123 MAPLE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2240
Practice Address - Country:US
Practice Address - Phone:516-374-6363
Practice Address - Fax:516-374-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256063207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty