496 Nesconset Hwy Suite 200 Smithtown Ny 11787

LBN: Mantia Medical Associates
496 Nesconset Hwy Suite 200 Smithtown Ny 11787 is an health care organization with primary practice located at 496 Nesconset Highway Ste 200, Smithtown NY 11787. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Mantia Medical Associates can be contacted via phone (631) 265-9111, or through Mantia, Augustus via phone (631) 265-9111.

Contact Information

Primary practice address
496 Nesconset Highway Ste 200 Smithtown NY 11787
Phone: (631) 265-9111
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mantia, Augustus
Phone: (631) 265-9111

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 182606 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 094617 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 124142 New York

Profile Details

NPI number 1477629400
LBN Legal business name Mantia Medical Associates
DBA Doing business as 496 Nesconset Hwy Suite 200 Smithtown Ny 11787
Authorized official Mantia, Augustus
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477629400 NPPES
New York MEDICAID 155862
New York MEDICAID 2785973
New York MEDICAID 1577013

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