Provider Demographics
NPI:1285820464
Name:NORTHPORT VA
Entity Type:Organization
Organization Name:NORTHPORT VA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-233-1751
Mailing Address - Street 1:79 MIDDLEVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NE
Mailing Address - Zip Code:11768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-233-1751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital