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Organization
PATCHOGUE MEDICAL GROUP LLP
Active
Organization
PATCHOGUE MEDICAL GROUP LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI SILVER-SMITH (PRACTICE MANAGER)
(631) 475-3900
Entity
Organization
Contact information
Practice address
1 E ROE BLVD, PATCHOGUE, NY 11772-2631
(631) 475-3900
(631) 475-5166
Mailing address
1 E ROE BLVD, PATCHOGUE, NY 11772-2631
(631) 475-3900
(631) 475-5166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03680820
—
NY
Enumeration date
07/25/2007
Last updated
11/20/2018
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