Provider Demographics
NPI:1285844340
Name:NORTH SUFFOLK COLON AND RECTAL SURGERY, PC
Entity Type:Organization
Organization Name:NORTH SUFFOLK COLON AND RECTAL SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-864-7870
Mailing Address - Street 1:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-0813
Mailing Address - Country:US
Mailing Address - Phone:631-864-7870
Mailing Address - Fax:631-864-7874
Practice Address - Street 1:1077 W JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3204
Practice Address - Country:US
Practice Address - Phone:631-864-7870
Practice Address - Fax:631-864-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty