Provider Demographics
NPI:1649651498
Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Entity type:Organization
Organization Name:WINTHROP COMMUNITY MEDICAL AFFILIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:D
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:SUITE 204
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3471
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 OLD COUNTRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4198
Practice Address - Country:US
Practice Address - Phone:516-741-4138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty