Provider Demographics
NPI:1568578078
Name:SUFFOLK PLASTIC SURGEONS, PC
Entity Type:Organization
Organization Name:SUFFOLK PLASTIC SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-751-4400
Mailing Address - Street 1:179 BELLE MEAD RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3456
Mailing Address - Country:US
Mailing Address - Phone:631-751-4400
Mailing Address - Fax:631-689-2375
Practice Address - Street 1:179 BELLE MEAD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3456
Practice Address - Country:US
Practice Address - Phone:631-751-4400
Practice Address - Fax:631-689-2375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========Medicare ID - Type UnspecifiedTAX NUMBER