Healthcare Provider Details

I. General information

NPI: 1518303809
Provider Name (Legal Business Name): MEDICAL SERVICES OF SUFFOLK COUNTY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7785 N STATE ST
LOWVILLE NY
13367-1229
US

IV. Provider business mailing address

PO BOX 742405
ATLANTA GA
30374-2104
US

V. Phone/Fax

Practice location:
  • Phone: 315-376-5200
  • Fax:
Mailing address:
  • Phone: 800-377-8721
  • Fax: 304-697-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALLAN RAPPAPORT
Title or Position: CHAIRMAN AND CEO
Credential: MD
Phone: 415-435-4591