Healthcare Provider Details

I. General information

NPI: 1891639191
Provider Name (Legal Business Name): SAAD SHAKIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MATHER HOSPITAL 75 NORTH COUNTRY ROAD
PORT JEFFERSON NY
11777
US

IV. Provider business mailing address

INTERNAL MEDICINE RESIDENCY PROGRAM, MATHER HOSPITAL 75 NORTH COUNTRY ROAD
PORT JEFFERSON NY
11777
US

V. Phone/Fax

Practice location:
  • Phone: 631-686-2549
  • Fax: 631-476-2874
Mailing address:
  • Phone: 631-686-2549
  • Fax: 631-476-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: