Provider Demographics
NPI:1295365864
Name:NORTH FORK SURGERY CENTER LLC
Entity Type:Organization
Organization Name:NORTH FORK SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADIPIETRO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:631-477-5353
Mailing Address - Street 1:700 BOISSEAU AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHOLD
Mailing Address - State:NY
Mailing Address - Zip Code:11971-0727
Mailing Address - Country:US
Mailing Address - Phone:631-477-5353
Mailing Address - Fax:631-477-5891
Practice Address - Street 1:700 BOISSEAU AVE
Practice Address - Street 2:
Practice Address - City:SOUTHOLD
Practice Address - State:NY
Practice Address - Zip Code:11971
Practice Address - Country:US
Practice Address - Phone:631-477-5353
Practice Address - Fax:631-477-5891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical