Provider Demographics
NPI:1972969111
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:516-877-2626
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 1:880 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2351
Practice Address - Country:US
Practice Address - Phone:516-541-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty