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Organization
CENTRAL SUFFOLK HOSPITAL
Active
Organization
CENTRAL SUFFOLK HOSPITAL
Active
Other names
Peconic Bay Medical Center, Peconic Bay Homehealth Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6397
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6397
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
5155601
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000250-7
BLUE CROSS
NY
05
—
00274328
—
NY
05
—
03000300
—
NY
Enumeration date
05/25/2006
Last updated
12/09/2022
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