Provider Demographics
NPI:1013164540
Name:OCEAN FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:OCEAN FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURATORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-665-5634
Mailing Address - Street 1:158 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8302
Mailing Address - Country:US
Mailing Address - Phone:631-665-5634
Mailing Address - Fax:631-665-5639
Practice Address - Street 1:158 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8302
Practice Address - Country:US
Practice Address - Phone:631-665-5634
Practice Address - Fax:631-665-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY48382Medicare UPIN
A100000170Medicare PIN