Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WISNOSKI (CFO, VP- FINANCE)
(631) 473-1320
Entity
Organization
Contact information
Practice address
75 NORTH COUNTRY RD, PORT JEFFERSON, NY 11777-2190
(631) 473-1320
Mailing address
625 BELLE TERRE ROAD, SUITE 100, PORT JEFFERSON, NY 11777
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
225349-1
NY
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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