Healthcare Provider Details

I. General information

NPI: 1932064896
Provider Name (Legal Business Name): ELEVATE PHYSICIAN CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 SMITHTOWN BYP STE 204
SMITHTOWN NY
11787-5024
US

IV. Provider business mailing address

738 SMITHTOWN BYP STE 204
SMITHTOWN NY
11787-5024
US

V. Phone/Fax

Practice location:
  • Phone: 631-413-4765
  • Fax:
Mailing address:
  • Phone: 631-413-4765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SURAJ SOOKHU
Title or Position: MD
Credential: MD
Phone: 631-413-4765