# JOHN T. MATHER MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mather Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790377513
- **Authorized official:** CHRISTINA IADANZA (ASSISTANCE VICE PRESIDENT)
- **Authorized official phone:** (631) 686-7830

## Contact information

- **Practice address:** 75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
- **Practice address phone:** (631) 473-1320
- **Mailing address:** PO BOX 6435, BRATTLEBORO, VT 05302-6435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2021
- **Last updated:** 02/04/2021