Organization
BROOKHAVEN MEMORIAL HOSP PSYCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON GIRAULO (VP)
(631) 654-7176
Entity
Organization
Contact information
Practice address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(631) 447-3076
Mailing address
PO BOX 6010, HAUPPAUGE, NY 11788-9010
(631) 840-5347
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02244824
—
NY
Enumeration date
11/29/2007
Last updated
11/29/2007
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