Provider Demographics
NPI:1639358799
Name:ACCESS OSTEOPATHY PC
Entity Type:Organization
Organization Name:ACCESS OSTEOPATHY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SMUTNY
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:631-486-4720
Mailing Address - Street 1:717 LARKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2600
Mailing Address - Country:US
Mailing Address - Phone:631-486-4720
Mailing Address - Fax:631-486-4722
Practice Address - Street 1:717 LARKFIELD RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2600
Practice Address - Country:US
Practice Address - Phone:631-486-4720
Practice Address - Fax:631-486-4722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-206232204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty