Organization
NORTH COUNTRY COLORECTAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA A BASILE M.D. (OWNER)
(631) 331-4672
Entity
Organization
Contact information
Practice address
41 N COUNTRY RD, PORT JEFFERSON, NY 11777-2160
(631) 331-4672
(631) 331-4239
Mailing address
41 N COUNTRY RD, PORT JEFFERSON, NY 11777-2160
(631) 331-4672
(631) 331-4239
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
206665
NY
Other
Enumeration date
10/11/2006
Last updated
03/14/2008
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