Provider Demographics
NPI:1225855299
Name:RONKONKOMA MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:RONKONKOMA MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-730-7970
Mailing Address - Street 1:4155 VETERANS MEMORIAL HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6063
Mailing Address - Country:US
Mailing Address - Phone:631-730-7970
Mailing Address - Fax:
Practice Address - Street 1:4155 VETERANS MEMORIAL HWY STE 6
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6063
Practice Address - Country:US
Practice Address - Phone:631-730-7970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty