Organization
SUFFOLK NEPHROLOGY CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EKAMBARAM ILAMATHI M.D. (PRESIDENT)
(631) 689-7800
Entity
Organization
Contact information
Practice address
2500 ROUTE 347, BLDG 14A, STONY BROOK, NY 11790-2555
(631) 689-7000
(631) 689-3016
Mailing address
2500 ROUTE 347, BLDG 14A, STONY BROOK, NY 11790-2555
(631) 689-7000
(631) 689-3016
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02524330
—
NY
Enumeration date
07/21/2005
Last updated
07/21/2022
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