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Organization
SMITH HAVEN PEDIATRICS
Active
Organization
SMITH HAVEN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ SOSULSKI (OFFICE COORDINATOR)
(631) 863-6321
Entity
Organization
Contact information
Practice address
269 E MAIN ST, BUILDING D, SMITHTOWN, NY 11787-2832
(631) 361-2121
(631) 361-2153
Mailing address
269 E MAIN ST, BUILDING D, SMITHTOWN, NY 11787-2832
(631) 361-2121
(631) 361-2153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487649182
NPI
NY
01
—
1922084920
NPI
NY
Enumeration date
04/19/2007
Last updated
08/22/2020
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