Fontanez, Modesto

Fontanez, Modesto is an individual health care provider with primary practice located at 2805 Veterans Memorial Hwy Suite 8, Ronkonkoma NY 11779-7647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Fontanez, Modesto can be contacted via phone (631) 738-8300.

Contact Information

Primary practice address
2805 Veterans Memorial Hwy Suite 8 Ronkonkoma NY 11779-7647
Phone: (631) 738-8300
Fax: (631) 738-8500
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 35083857 Ohio
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 181810-4 New York

Profile Details

NPI number 1851395826
LBN Legal business name Fontanez, Modesto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Jan 4th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851395826 NPPES
Ohio MEDICAID 2463258

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