Organization
CENTRAL SUFFOLK HOSPTIAL
Active
Other names
PECONIC BAY MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL O'DONNELL (SENIOR VP FINANCE/CFO)
(631) 548-6000
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6101
(631) 548-6007
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6101
(631) 548-6007
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/31/2013
Last updated
08/31/2016
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