Provider Demographics
NPI:1558443176
Name:SMITHTOWN PSYCHIATRIC SERVICES LLP
Entity Type:Organization
Organization Name:SMITHTOWN PSYCHIATRIC SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-265-0909
Mailing Address - Street 1:2 BROOKSITE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3455
Mailing Address - Country:US
Mailing Address - Phone:631-265-0909
Mailing Address - Fax:631-265-0757
Practice Address - Street 1:2 BROOKSITE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3455
Practice Address - Country:US
Practice Address - Phone:631-265-0909
Practice Address - Fax:631-265-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01520305Medicaid
W86581Medicare ID - Type Unspecified