33D2086631 CLIA NUMBER - MAMARONECK MEDICAL PLLC

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Laboratory Demographics

CLIA Number: 33D2086631

Facility Name: MAMARONECK MEDICAL PLLC

Facility Address:
933 MAMARONECK AVENUE, SUITE 102
MAMARONECK, NY
ZIP 10543
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Facility Phone Number: 914 630-1800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1992101984

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	33D2086631
LAB Type	Physician Office
Facility Name	MAMARONECK MEDICAL PLLC
Street	933 MAMARONECK AVENUE, SUITE 102
City	MAMARONECK
State	NY
ZIP	10543
Phone	914 630-1800
CertificateType	4
CertificateEffectiveDate	11/7/2022
CertificateExpirationDate	11/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024