Organization
SUFFOLK OBGYN LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX SRETER (PRACTICE ADMINISTRATION)
(631) 473-7171
Entity
Organization
Contact information
Practice address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Mailing address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC3107
RAILROAD MEDICARE
—
Enumeration date
10/05/2006
Last updated
07/22/2010
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