Provider Demographics
NPI:1639216476
Name:NORTH SUFFOLK MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NORTH SUFFOLK MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIOTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-239-1677
Mailing Address - Street 1:50 KARL AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2744
Mailing Address - Country:US
Mailing Address - Phone:631-239-1677
Mailing Address - Fax:631-724-3967
Practice Address - Street 1:50 KARL AVE STE 301
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2744
Practice Address - Country:US
Practice Address - Phone:631-239-1677
Practice Address - Fax:631-724-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183593170100000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW34601Medicare PIN