# JOHN T. MATHER MEMORIAL HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1639585706
- **Authorized official:** MR. JOSEPH WISNOSKI (SR. VP & CMO)
- **Authorized official phone:** (631) 473-1320

## Contact information

- **Practice address:** 75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
- **Practice address phone:** (631) 476-2768
- **Practice address fax:** (631) 474-4939
- **Mailing address:** 75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
- **Mailing address phone:** (631) 476-2768
- **Mailing address fax:** (631) 474-4939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | — | — |
| 261QR0800X | Recovery Care Clinic/Center | — | — | — |
| 283X00000X | Rehabilitation Hospital | — | — | — |

## Other

- **Enumeration date:** 07/09/2014
- **Last updated:** 07/11/2014