Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WISNOSKI (CFO)
(631) 473-1320
Entity
Organization
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
625 BELLE TERRE RD, SUITE100, PORT JEFFERSON, NY 11777-2316
(631) 686-7689
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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