Provider Demographics
NPI:1326403080
Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, PC
Entity Type:Organization
Organization Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, PC
Other - Org Name:GARDEN CITY PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
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 2:204
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3471
Mailing Address - Country:US
Mailing Address - Phone:516-576-5822
Mailing Address - Fax:516-576-5801
Practice Address - Street 1:1000 FRANKLIN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2926
Practice Address - Country:US
Practice Address - Phone:516-248-6868
Practice Address - Fax:516-248-6841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty