# PECONIC BAY MEDICAL CENTER

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

## Provider details

- **NPI number:** 1760769624
- **Authorized official:** DR. GEORGE RUGGIERO DO (DME)
- **Authorized official phone:** (631) 548-6446

## Contact information

- **Practice address:** 1300 ROANOKE AVE, RIVERHEAD, NY 11901
- **Practice address phone:** (631) 548-6446
- **Mailing address:** 1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
- **Mailing address phone:** (631) 548-6446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2011
- **Last updated:** 11/07/2011