Organization
CENTRAL SUFFOLK HOSPITAL
Active
Other names
Peconic Bay Medical Center Professional Group Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MITCHELL (PRESIDENT/CEO)
(631) 548-6064
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6116
(631) 548-6007
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6116
(631) 548-6007
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/14/2007
Last updated
03/19/2015
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