| Suffolk Medical Specialist, Pllc | |
|
1110 Hallock Ave Port Jefferson Station NY 11776-1210 | |
| (631) 476-9100 | |
| (631) 476-4919 |
| Full Name | Suffolk Medical Specialist, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1110 Hallock Ave, Port Jefferson Station, New York |
| Authorized Official Name and Position | Norman R Bennett (OWNER) |
| Authorized Official Contact | 6314769100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Medical Specialist, Pllc 1110 Hallock Ave Port Jefferson Station NY 11776-1210 Ph: (631) 476-9100 | Suffolk Medical Specialist, Pllc 1110 Hallock Ave Port Jefferson Station NY 11776-1210 Ph: (631) 476-9100 |
| NPI Number | 1710950688 |
|---|---|
| Provider Enumeration Date | 02/09/2006 |
| Last Update Date | 12/12/2014 |
| Medicare PECOS PAC ID | 3274424775 |
|---|---|
| Medicare Enrollment ID | O20071214000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710950688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 159940 (New York) | Primary |
| Provider Name | Norman Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700857786 PECOS PAC ID: 4688669724 Enrollment ID: I20040507001352 |
| Provider Name | Kelly A Godberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053833962 PECOS PAC ID: 1557635927 Enrollment ID: I20170922003171 |
Michael W. Mendelson, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5360 Nesconset Hwy Ste B, Port Jefferson Station, NY 11776 Phone: 631-331-3200 Fax: 631-331-3694 | |
Harbor Medical Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 Terryville Rd, Port Jefferson Station, NY 11776 Phone: 631-928-2002 Fax: 206-202-3956 | |
North Shore Hematology/oncology Associates Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 49 Nesconset Hwy, Port Jefferson Station, NY 11776 Phone: 631-751-3000 Fax: 631-751-0506 | |
Port Jeff Medical Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Hallock Ave, Port Jefferson Station, NY 11776 Phone: 631-642-1100 Fax: 631-642-1190 | |
North Shore Immediate Medical Care P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Patchogue Rd, Port Jefferson Station, NY 11776 Phone: 631-331-1100 Fax: 631-331-0223 | |
Haven Medical Services, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1350 Route 112, Port Jefferson Station, NY 11776 Phone: 631-473-3304 Fax: 631-474-1692 | |
Aziz Chaudry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2b Medical Park Drive, Port Jefferson Station, NY 11776 Phone: 631-928-1830 Fax: 631-928-1830 |