# SUFFOLK THORACIC SURGERY PC

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

## Provider details

- **NPI number:** 1902297468
- **Authorized official:** MR. MATHEW JAMES (BILLING MANAGER)
- **Authorized official phone:** (631) 827-8159

## Contact information

- **Practice address:** 21 VANTAGE CT, PORT JEFFERSON, NY 11777-2242
- **Practice address phone:** (631) 827-8159
- **Practice address fax:** (631) 368-1538
- **Mailing address:** 21 VANTAGE CT, PORT JEFFERSON, NY 11777-2242
- **Mailing address phone:** (631) 827-8159
- **Mailing address fax:** (631) 368-1538

## Taxonomy

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

## Other

- **Enumeration date:** 02/05/2015
- **Last updated:** 02/05/2015