# SMITHTOWN ASC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184505299
- **Authorized official:** BILLY INGRAM (MEMBER)
- **Authorized official phone:** (267) 455-4855

## Contact information

- **Practice address:** 61 SOUTHERN BLVD STE 1-4, NESCONSET, NY 11767-1089
- **Practice address phone:** (111) 111-1111
- **Mailing address:** 61 SOUTHERN BLVD STE 1-4, NESCONSET, NY 11767-1089
- **Mailing address phone:** (631) 546-0802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/08/2025
- **Last updated:** 09/18/2026