# VASCULAR SURGERY ASSOCIATE OF SUFFOLK COUNTY, PLLC

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

## Provider details

- **NPI number:** 1477893113
- **Authorized official:** DANIELLE COWAN (MANAGER)
- **Authorized official phone:** (631) 569-5410

## Contact information

- **Practice address:** 33 MEDFORD AVE STE A, PATCHOGUE, NY 11772-1222
- **Practice address phone:** (631) 569-5410
- **Practice address fax:** (631) 569-5413
- **Mailing address:** 33 MEDFORD AVE STE A, PATCHOGUE, NY 11772-1222
- **Mailing address phone:** (631) 569-5410
- **Mailing address fax:** (631) 569-5413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2013
- **Last updated:** 12/23/2025