Organization
CUTCHOGUE INTERNAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN IMPELLIZERI D.O. (MANGING MEMBER)
(631) 734-7670
Entity
Organization
Contact information
Practice address
32645 MAIN RD, CUTCHOGUE, NY 11935-1364
(631) 734-7670
(631) 734-7670
Mailing address
PO BOX 1159, CUTCHOGUE, NY 11935-0874
(631) 734-7670
(631) 734-7673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
224524
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02444824
—
NY
Enumeration date
09/08/2005
Last updated
08/22/2020
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