Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
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, SUITE 100, PORT JEFFERSON, NY 11777-2316
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
222725
NY
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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