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Specialty details in registry · West Babylon, NY

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At a glance

457 18Th St, West Babylon, NY 11704-2201

NPPES record updated Aug 5, 2013. Public records can lag behind changes at a practice.

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Practice location

457 18Th St
West Babylon, NY 11704-2201

Professional details: NPI, taxonomy & registry record

NPI1033541776

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 252Y00000X
Enumeration date: Aug 5, 2013
Record updated: Aug 5, 2013

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

252Y00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

457 18Th St
West Babylon, NY 11704-2201

Phone: (631) 236-7644

Mailing address

457 18TH ST

WEST BABYLON, NY 117042201

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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