| Dr Peter A Boulukos, MD | |
|
471 Montauk Hwy, West Islip, NY 11795-4414 | |
| (631) 849-1050 | |
| (631) 849-1052 |
| Full Name | Dr Peter A Boulukos |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 471 Montauk Hwy, West Islip, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184782260 | NPI | - | NPPES |
| PB027A5210 | Other | NY | BLUE CROSS BLUE SHILED |
| 141481-2 CAN | Other | NY | WORKERS COMPENSATION |
| 00535199 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 141481-1 (New York) | Primary |
| Entity Name | Long Island Anesthesia Physicians Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952387276 PECOS PAC ID: 7113825381 Enrollment ID: O20040106000103 |
| Entity Name | Suffolk Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871869305 PECOS PAC ID: 2567609464 Enrollment ID: O20130514000209 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Peter A Boulukos, MD 12 Grouse Ln, Huntington, NY 11743-1029 Ph: (516) 356-3888 | Dr Peter A Boulukos, MD 471 Montauk Hwy, West Islip, NY 11795-4414 Ph: (631) 849-1050 |
Terence James Omalley, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Montauk Hwy, Good Samaritan Hospital Medical Center, West Islip, NY 11795 Phone: 631-376-4088 Fax: 631-376-3289 | |
Dr. Claude Simon Gerstenhaber, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Montauk Hwy, Good Samaritan Hospital Center, West Islip, NY 11795 Phone: 631-376-4088 | |
Roxana Teodora Sacarin, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Montauk Hwy, Good Samaritan Hospital, West Islip, NY 11795 Phone: 833-547-7463 | |
Dr. Christopher James Lafferty, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Montauk Hwy, West Islip, NY 11795 Phone: 631-376-3000 | |
Eric Fanaee, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 380 Montauk Hwy, West Islip, NY 11795 Phone: 631-422-5371 | |
Rodolfo M Domingo, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Montauk Hwy, Good Samaritan Hospital Medical Center, West Islip, NY 11795 Phone: 631-376-4088 |