| Medicenter Northport | |
|
399 Fort Salonga Rd Northport NY 11768-3045 | |
| (631) 757-5400 | |
| (631) 757-4178 |
| Full Name | Medicenter Northport |
|---|---|
| Speciality | Family Medicine |
| Location | 399 Fort Salonga Rd, Northport, New York |
| Authorized Official Name and Position | Robert E. Scully (DIRECTOR) |
| Authorized Official Contact | 6317575400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicenter Northport 399 Fort Salonga Rd Northport NY 11768-3045 Ph: (631) 757-5400 | Medicenter Northport 399 Fort Salonga Rd Northport NY 11768-3045 Ph: (631) 757-5400 |
| NPI Number | 1992731426 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 11/18/2013 |
| Medicare PECOS PAC ID | 8729979844 |
|---|---|
| Medicare Enrollment ID | O20040320000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992731426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 164326 (New York) | Primary |
| Provider Name | Robert E Scully |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346281086 PECOS PAC ID: 0345131462 Enrollment ID: I20040320000435 |
| Provider Name | Joseph Stephen Mauceri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801992524 PECOS PAC ID: 3971510538 Enrollment ID: I20060307000829 |
| Provider Name | Syed Ali Afzal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558318550 PECOS PAC ID: 5698822534 Enrollment ID: I20090413000243 |
| Provider Name | Debra Pincus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548255102 PECOS PAC ID: 7416006044 Enrollment ID: I20090601000214 |
| Provider Name | Arthur Kornblit |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255413050 PECOS PAC ID: 4981889193 Enrollment ID: I20110504000233 |
| Provider Name | Thomas J Bolte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366555781 PECOS PAC ID: 8426949561 Enrollment ID: I20131204000608 |
| Provider Name | Ajay R Balladin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134541733 PECOS PAC ID: 1456570829 Enrollment ID: I20140917000453 |
| Provider Name | Jacqueline P Pape |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114374709 PECOS PAC ID: 2567741689 Enrollment ID: I20161114000884 |
| Provider Name | Suzanne C Carmino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952957177 PECOS PAC ID: 0840522892 Enrollment ID: I20191024002300 |
| Provider Name | Kelley Considine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982137857 PECOS PAC ID: 0648698548 Enrollment ID: I20200901001300 |
Compcare Medical, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Paddock Dr, Northport, NY 11768 Phone: 631-332-6704 | |
Medredefined Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 345 Waterside Rd, Northport, NY 11768 Phone: 631-857-4439 | |
Quality Medical Fitness, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 389 Fort Salonga Rd Ste 3, Northport, NY 11768 Phone: 631-424-1170 Fax: 631-424-1171 | |
Kraydman Medical, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 49 Dolphin Ln, Northport, NY 11768 Phone: 631-767-7724 Fax: 631-271-9155 | |
Northport Family Medicine P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Main St, Northport, NY 11768 Phone: 631-261-4445 Fax: 631-261-3710 | |
Progressive Medical Fitness Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 389 Fort Salonga Rd Ste 2, Northport, NY 11768 Phone: 631-201-2474 Fax: 631-382-8325 | |
Richard P. Boughal, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Main St, Northport, NY 11768 Phone: 631-261-3243 Fax: 631-757-6804 |