| Atlantic SC LLC | |
|
1145 Montauk Hwy West Islip NY 11795-4909 | |
| (631) 743-1145 | |
| Not Available |
| Full Name | Atlantic SC LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1145 Montauk Hwy, West Islip, New York |
| Authorized Official Name and Position | Marianne Jorgensen (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 6317431145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic SC LLC 1145 Montauk Hwy West Islip NY 11795-4909 Ph: (631) 743-1145 | Atlantic SC LLC 1145 Montauk Hwy West Islip NY 11795-4909 Ph: (631) 743-1145 |
| NPI Number | 1295494359 |
|---|---|
| Provider Enumeration Date | 12/15/2021 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/15/2022 |
| Medicare PECOS PAC ID | 1658750195 |
|---|---|
| Medicare Enrollment ID | O20220614000999 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295494359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (NU) | Primary |
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