Provider Demographics
NPI:1639804628
Name:TRUE NORTH MEDICAL AT NORTH SUFFOLK PLLC
Entity Type:Organization
Organization Name:TRUE NORTH MEDICAL AT NORTH SUFFOLK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-364-9119
Mailing Address - Street 1:600 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3802
Mailing Address - Country:US
Mailing Address - Phone:516-419-0412
Mailing Address - Fax:
Practice Address - Street 1:1010 ROUTE 112 STE 300
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3386
Practice Address - Country:US
Practice Address - Phone:631-886-4985
Practice Address - Fax:631-364-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty