Organization
JOHN T MATHER MEMORIAL HOSPITAL
Active
Other names
Bariatric Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WISNOSKI (VP FINANCE)
(631) 473-1320
Entity
Organization
Contact information
Practice address
75 N COUNTRY RD, SUITE 201, PORT JEFFERSON, NY 11777-2119
(631) 689-0220
(631) 417-3042
Mailing address
100 HIGHLANDS BLVD, BOX 9, PORT JEFFERSON, NY 11777-2320
(631) 686-7809
(631) 686-7972
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
11/20/2015
Last updated
04/08/2016
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