Provider Demographics
NPI:1376073825
Name:WINTHROP COMMUNITY MEDICAL AFFILIATES PC
Entity Type:Organization
Organization Name:WINTHROP COMMUNITY MEDICAL AFFILIATES PC
Other - Org Name:SUFFOLK CARDIOVASCULAR CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-663-2216
Mailing Address - Street 1:700 HICKSVILLE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1920 DEER PARK AVE STE 104
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3314
Practice Address - Country:US
Practice Address - Phone:631-392-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINTHROP COMMUNITY MEDICAL AFFILIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty