Provider Demographics
NPI:1619284650
Name:SUFFOLK AMBULATORY SURGERY, PLLC
Entity Type:Organization
Organization Name:SUFFOLK AMBULATORY SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
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 N BELLE MEAD RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3528
Mailing Address - Country:US
Mailing Address - Phone:631-751-4400
Mailing Address - Fax:631-689-2375
Practice Address - Street 1:179 N BELLE MEAD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3528
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:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050722261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY050722OtherNYS OFFICE OF PROFESSIONS