NPIMap

Organization Active NPI

Bohemia Medical, PC

  • General Practice Physician
  • Ronkonkoma, NY
National Provider Identifier
1063440659
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
188150 Issued in NY
Legal business name
BOHEMIA MEDICAL, PC
Practice address
4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063
Phone
(631) 412-4800
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barry WeinNPI 1366477507
Title
DO
Phone
(631) 738-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 188150 NY Primary

Addresses

Primary practice location

4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063

Mailing address

4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063
Phone (516) 234-0018

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1063440659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 VETERANS MEMORIAL HWY STE 5",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796063",
            "telephone_number": "516-234-0018",
            "fax_number": "888-487-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 VETERANS MEMORIAL HWY STE 5",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796063",
            "telephone_number": "631-412-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOHEMIA MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "WEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "631-738-8300"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "188150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.