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Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WISNOSKI (SR. VP & CMO)
(631) 473-1320
Entity
Organization
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 476-2768
(631) 474-4939
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 476-2768
(631) 474-4939
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
283X00000X
Rehabilitation Hospital
—
—
Other
Enumeration date
07/09/2014
Last updated
07/11/2014
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