Provider Demographics
NPI:1043704380
Name:TMS MEDICAL THERAPY OF SUFFOLK COUNTY PC
Entity Type:Organization
Organization Name:TMS MEDICAL THERAPY OF SUFFOLK COUNTY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-759-0919
Mailing Address - Street 1:1000 FORT SALONGA RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2261
Mailing Address - Country:US
Mailing Address - Phone:631-759-0919
Mailing Address - Fax:888-567-5146
Practice Address - Street 1:1000 FORT SALONGA RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2261
Practice Address - Country:US
Practice Address - Phone:631-759-0919
Practice Address - Fax:888-567-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty