Healthcare Provider Details

I. General information

NPI: 1770580516
Provider Name (Legal Business Name): VISITING NURSE SERVICE AND HOSPICE OF SUFFOLK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 MAIN ST
NORTHPORT NY
11768
US

IV. Provider business mailing address

505 MAIN ST
NORTHPORT NY
11768-1954
US

V. Phone/Fax

Practice location:
  • Phone: 631-261-7200
  • Fax: 631-912-1121
Mailing address:
  • Phone: 631-261-7200
  • Fax: 631-912-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number5125600
License Number StateNY

VIII. Authorized Official

Name: SILVIA COTA
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, BSN, RN, CEN
Phone: 631-261-7200