| Middle Country Endocrinology, Pc | |
|
285 Middle Country Rd Suite 105 Smithtown NY 11787-2978 | |
| (631) 509-0390 | |
| Not Available |
| Full Name | Middle Country Endocrinology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 285 Middle Country Rd, Smithtown, New York |
| Authorized Official Name and Position | Sherry K Sussman (CEO) |
| Authorized Official Contact | 6315090390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Country Endocrinology, Pc 285 Middle Country Rd Suite 105 Smithtown NY 11787-2978 Ph: (631) 509-0390 | Middle Country Endocrinology, Pc 285 Middle Country Rd Suite 105 Smithtown NY 11787-2978 Ph: (631) 509-0390 |
| NPI Number | 1295068930 |
|---|---|
| Provider Enumeration Date | 09/14/2009 |
| Last Update Date | 09/14/2009 |
| Medicare PECOS PAC ID | 9032256169 |
|---|---|
| Medicare Enrollment ID | O20091022000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295068930 | NPI | - | NPPES |
| 1235176280 | Other | NPI # INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 205106 (New York) | Primary |
| Provider Name | Sherry K Sussman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1235176280 PECOS PAC ID: 0446344758 Enrollment ID: I20091022000351 |
| Provider Name | Deepa Aravind |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1669677332 PECOS PAC ID: 4486781747 Enrollment ID: I20100420000097 |
| Provider Name | Beena Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699201970 PECOS PAC ID: 9234401340 Enrollment ID: I20170824002167 |
| Provider Name | Tara Mann |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1639510837 PECOS PAC ID: 9739463969 Enrollment ID: I20170831001453 |
| Provider Name | Diane Grassi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063917136 PECOS PAC ID: 7416203385 Enrollment ID: I20180706001592 |
| Provider Name | Karen Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669984258 PECOS PAC ID: 0547597668 Enrollment ID: I20190813001937 |
Raul R. Trinchet, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 285 Middle Country Road, Suite Ll-2, Smithtown, NY 11787 Phone: 631-979-4541 Fax: 631-979-4546 | |
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