Basic Information
| Provider Information | |||||||||
| NPI: | 1205022837 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUND FAMILY MEDICINE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 54 WOODVILLE RD | ||||||||
| Address2: | |||||||||
| City: | SHOREHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117861331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6319291256 | ||||||||
| FaxNumber: | 6319298313 | ||||||||
| Practice Location | |||||||||
| Address1: | 54 WOODVILLE RD | ||||||||
| Address2: | |||||||||
| City: | SHOREHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117861331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6319291256 | ||||||||
| FaxNumber: | 6319298313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2007 | ||||||||
| LastUpdateDate: | 11/17/2010 | ||||||||
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| AuthorizedOfficialLastName: | RUGGIERO | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6319291256 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.