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Organization
SUFFOLK MEDICAL SPECIALIST, PLLC
Active
Organization
SUFFOLK MEDICAL SPECIALIST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NORMAN R BENNETT M.D. (OWNER)
(631) 476-9100
Entity
Organization
Contact information
Practice address
1110 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1210
(631) 476-9100
(631) 476-4919
Mailing address
1110 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1210
(631) 476-9100
(631) 476-4919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
159940
NY
Other
Enumeration date
02/09/2006
Last updated
12/12/2014
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