Provider Demographics
NPI:1144353152
Name:OCEAN PHYSICIANS PC
Entity type:Organization
Organization Name:OCEAN PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:KONG WAH
Authorized Official - Last Name:CHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-378-4949
Mailing Address - Street 1:33 NORTH OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520
Mailing Address - Country:US
Mailing Address - Phone:516-378-4949
Mailing Address - Fax:516-379-8026
Practice Address - Street 1:33 NORTH OCEAN AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520
Practice Address - Country:US
Practice Address - Phone:516-378-4949
Practice Address - Fax:516-379-8026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1366991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W93821Medicare ID - Type Unspecified