| True North Medical At North Suffolk Pllc | |
|
1010 Route 112 Ste 300 Port Jefferson Station NY 11776-3386 | |
| (631) 886-4985 | |
| (631) 364-9119 |
| Full Name | True North Medical At North Suffolk Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1010 Route 112 Ste 300, Port Jefferson Station, New York |
| Authorized Official Name and Position | Warren Spinner (ADMINISTRATOR) |
| Authorized Official Contact | 6313649119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True North Medical At North Suffolk Pllc 600 Community Dr Manhasset NY 11030-3802 Ph: (516) 419-0412 | True North Medical At North Suffolk Pllc 1010 Route 112 Ste 300 Port Jefferson Station NY 11776-3386 Ph: (631) 886-4985 |
| NPI Number | 1639804628 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Medicare PECOS PAC ID | 0345618088 |
|---|---|
| Medicare Enrollment ID | O20221130001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639804628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | David Joseph Panasci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528038015 PECOS PAC ID: 3971493263 Enrollment ID: I20040318001793 |
| Provider Name | Seema V Nambiar |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1912985656 PECOS PAC ID: 6305833039 Enrollment ID: I20040426001810 |
| Provider Name | Alan Ettinger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467432625 PECOS PAC ID: 1052379088 Enrollment ID: I20041222000438 |
| Provider Name | Deborah Galloway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346292869 PECOS PAC ID: 7911918347 Enrollment ID: I20060519000106 |
| Provider Name | Warren D Spinner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164617544 PECOS PAC ID: 2961575857 Enrollment ID: I20080725000339 |
| Provider Name | Jennifer Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619139201 PECOS PAC ID: 9638340649 Enrollment ID: I20110923000391 |
| Provider Name | John Kelemen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811973449 PECOS PAC ID: 3678583440 Enrollment ID: I20120203000668 |
| Provider Name | Beth M Silverstein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013104660 PECOS PAC ID: 9234389693 Enrollment ID: I20121019000189 |
| Provider Name | Ross E Lipton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518256767 PECOS PAC ID: 9739330861 Enrollment ID: I20121119000154 |
| Provider Name | Elenora Achildiyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306296751 PECOS PAC ID: 1850679432 Enrollment ID: I20161102001265 |
| Provider Name | Danielle Bruno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497022107 PECOS PAC ID: 0648536508 Enrollment ID: I20171108003142 |
| Provider Name | Svetlana Karshigeyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558860395 PECOS PAC ID: 7810251873 Enrollment ID: I20180430000937 |
| Provider Name | Maryana Liedke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386987956 PECOS PAC ID: 3274881800 Enrollment ID: I20180730002270 |
| Provider Name | Shakira Shanker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144631987 PECOS PAC ID: 9032541701 Enrollment ID: I20191119000097 |
| Provider Name | Tanya Kapoor-maini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124439328 PECOS PAC ID: 1951677434 Enrollment ID: I20201023000013 |
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