Organization
JOHN T. MATHER MEMORIAL HOSPITAL
Active
Other names
Breast Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WISNOSKI (VICE-PRESIDENT FINANCE)
(631) 473-1320
Entity
Organization
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
(631) 686-7972
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
(631) 686-7972
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NY
Other
Enumeration date
04/03/2007
Last updated
04/29/2015
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