| Medicenter | |
|
365 W Jericho Tpke Huntington NY 11743-6362 | |
| (631) 423-5400 | |
| (631) 423-5423 |
| Full Name | Medicenter |
|---|---|
| Speciality | Internal Medicine |
| Location | 365 W Jericho Tpke, Huntington, New York |
| Authorized Official Name and Position | Robert E. Scully (PRESIDENT) |
| Authorized Official Contact | 6314235400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicenter 365 W Jericho Tpke Huntington NY 11743-6362 Ph: (631) 423-5400 | Medicenter 365 W Jericho Tpke Huntington NY 11743-6362 Ph: (631) 423-5400 |
| NPI Number | 1831242668 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5890686976 |
|---|---|
| Medicare Enrollment ID | O20080925000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831242668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 164326 (New York) | Primary |
| Provider Name | Robert E Scully |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346281086 PECOS PAC ID: 0345131462 Enrollment ID: I20040320000435 |
| Provider Name | Anil M Kanth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346209319 PECOS PAC ID: 0840234779 Enrollment ID: I20050613000401 |
| Provider Name | Joseph Stephen Mauceri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801992524 PECOS PAC ID: 3971510538 Enrollment ID: I20060307000829 |
| Provider Name | Syed Ali Afzal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558318550 PECOS PAC ID: 5698822534 Enrollment ID: I20090413000243 |
| Provider Name | Debra Pincus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548255102 PECOS PAC ID: 7416006044 Enrollment ID: I20090601000214 |
| Provider Name | Joseph Vitoulis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154402030 PECOS PAC ID: 1153475090 Enrollment ID: I20090812000448 |
| Provider Name | Arthur Kornblit |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255413050 PECOS PAC ID: 4981889193 Enrollment ID: I20110504000233 |
| Provider Name | Thomas J Bolte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366555781 PECOS PAC ID: 8426949561 Enrollment ID: I20131204000608 |
| Provider Name | Ajay R Balladin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134541733 PECOS PAC ID: 1456570829 Enrollment ID: I20140917000453 |
| Provider Name | Jacqueline P Pape |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114374709 PECOS PAC ID: 2567741689 Enrollment ID: I20161114000884 |
| Provider Name | Suzanne C Carmino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952957177 PECOS PAC ID: 0840522892 Enrollment ID: I20191024002300 |
| Provider Name | Kelley Considine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982137857 PECOS PAC ID: 0648698548 Enrollment ID: I20200901001300 |
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