| Suffolk Pediatric, Pc | |
|
45 W Suffolk Ave 2nd Floor Central Islip NY 11722-2156 | |
| (631) 582-2228 | |
| (631) 582-4881 |
| Full Name | Suffolk Pediatric, Pc |
|---|---|
| Speciality | Pediatrics |
| Location | 45 W Suffolk Ave, Central Islip, New York |
| Authorized Official Name and Position | David Efrain Sanchez (PRESIDENT) |
| Authorized Official Contact | 6315822228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Pediatric, Pc 45 W Suffolk Ave 2nd Floor Central Islip NY 11722-2156 Ph: (631) 582-2228 | Suffolk Pediatric, Pc 45 W Suffolk Ave 2nd Floor Central Islip NY 11722-2156 Ph: (631) 582-2228 |
| NPI Number | 1427355775 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 02/23/2011 |
| Medicare PECOS PAC ID | 0648454116 |
|---|---|
| Medicare Enrollment ID | O20110407000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427355775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 258769-1 (New York) | Secondary |
| 208000000X | Pediatrics | 215692-1 (New York) | Primary |
| Provider Name | Marie C Jacques |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457488082 PECOS PAC ID: 1850383712 Enrollment ID: I20040331001162 |
Long Island Select Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 159 Carleton Ave, Central Islip, NY 11722 Phone: 631-650-2510 Fax: 631-650-0497 | |
Vertex Physical Therapy Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 46 W Suffolk Avenue, Central Islip, NY 11722 Phone: 407-758-3923 | |
Southside Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 W Suffolk Ave, Central Islip, NY 11722 Phone: 631-853-2710 | |
Taimur Ahmad D.o. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1025 Islip Ave, Central Islip, NY 11722 Phone: 631-234-3800 Fax: 631-234-3801 | |
Suffolk County Dept Of Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 W Suffolk Ave, Central Islip, NY 11722 Phone: 631-853-2710 | |
Carl-henri Sanchez, Md. Pc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 W Suffolk Ave, B, Central Islip, NY 11722 Phone: 631-231-4681 Fax: 631-231-4398 |