| South Brookhaven Health Center West | |
|
365 E Main St Patchogue NY 11772-3145 | |
| (631) 854-1200 | |
| (631) 854-1310 |
| Full Name | South Brookhaven Health Center West |
|---|---|
| Speciality | Clinic/center |
| Location | 365 E Main St, Patchogue, New York |
| Authorized Official Name and Position | James L Tomarken (COMMISSIONER) |
| Authorized Official Contact | 6318540100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Brookhaven Health Center West P.o. Box 9006 3500 Sunrise Hwy, Suite 124 Great River NY 11739-9006 Ph: (631) 854-0000 | South Brookhaven Health Center West 365 E Main St Patchogue NY 11772-3145 Ph: (631) 854-1200 |
| NPI Number | 1801990015 |
|---|---|
| Provider Enumeration Date | 09/08/2006 |
| Last Update Date | 10/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801990015 | NPI | - | NPPES |
| 03003692 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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