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Organization
CENTRAL SUFFOLK HOSPITAL
Active
Organization
CENTRAL SUFFOLK HOSPITAL
Active
Other names
Peconic Bay Medical Center Professional Group Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MITCHELL (PRESIDENT/CEO)
(631) 548-6064
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6116
(631) 548-6007
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6116
(631) 548-6007
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/14/2007
Last updated
03/19/2015
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