Provider Demographics
NPI:1851319305
Name:FIVE TOWNS TOTAL MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:FIVE TOWNS TOTAL MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/NEUROLOGISY
Authorized Official - Prefix:
Authorized Official - First Name:FAZZINI
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRICO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-371-2225
Mailing Address - Street 1:275 ROCKAWAY TPKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1232
Mailing Address - Country:US
Mailing Address - Phone:516-371-2225
Mailing Address - Fax:516-371-3773
Practice Address - Street 1:275 ROCKAWAY TPKE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1232
Practice Address - Country:US
Practice Address - Phone:516-371-2225
Practice Address - Fax:516-371-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty