Organization
SUFFOLK SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES A WALTERS RN, BA (ADMINISTRATOR)
(631) 205-9090
Entity
Organization
Contact information
Practice address
1500 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-1800
(631) 205-9090
Mailing address
1500 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-1800
(631) 205-9090
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
5151207R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02553208
—
NY
Enumeration date
09/16/2006
Last updated
06/19/2013
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