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Organization
CENTRAL SUFFOLK HOSPITAL
Active
Organization
CENTRAL SUFFOLK HOSPITAL
Active
Other names
Peconic Bay Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6508
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6007
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6007
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
282N00000X
General Acute Care Hospital
Primary
5155000H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000250-7
BLUE CROSS
NY
01
—
0007461
AETNA US HEALTHCARE
NY
05
—
00274328
—
NY
05
—
03000300
—
NY
01
—
5225-7
BC DIALYSIS
NY
01
—
H03149
OXFORD
NY
Enumeration date
06/21/2005
Last updated
07/31/2025
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