Provider Demographics
NPI:1659639110
Name:SMITHTOWN HEALTH LLC
Entity Type:Organization
Organization Name:SMITHTOWN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FOROHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-488-9427
Mailing Address - Street 1:50 ROUTE 111
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3738
Mailing Address - Country:US
Mailing Address - Phone:516-488-9427
Mailing Address - Fax:800-557-3140
Practice Address - Street 1:50 ROUTE 111
Practice Address - Street 2:SUITE 302
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3738
Practice Address - Country:US
Practice Address - Phone:516-488-9427
Practice Address - Fax:800-557-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty