Provider Demographics
NPI:1972718211
Name:HEMATOLOGY-ONCOLOGY ASSOCIATES OF WESTERN SUFFOLK PC
Entity Type:Organization
Organization Name:HEMATOLOGY-ONCOLOGY ASSOCIATES OF WESTERN SUFFOLK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ADMINISTATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-666-6752
Mailing Address - Street 1:24 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8301
Mailing Address - Country:US
Mailing Address - Phone:631-666-6752
Mailing Address - Fax:631-666-0684
Practice Address - Street 1:24 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8301
Practice Address - Country:US
Practice Address - Phone:631-666-6752
Practice Address - Fax:631-666-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW06832Medicare PIN
NY4236600001Medicare NSC