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Organization
SMITHTOWN ASC, LLC
Active
Organization
SMITHTOWN ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY INGRAM (MEMBER)
(267) 455-4855
Entity
Organization
Contact information
Practice address
61 SOUTHERN BLVD STE 1-4, NESCONSET, NY 11767-1089
(111) 111-1111
Mailing address
61 SOUTHERN BLVD STE 1-4, NESCONSET, NY 11767-1089
(631) 546-0802
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/08/2025
Last updated
09/18/2026
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