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General NPI Number Information
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NPI Number | 1225762503
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Entity Type | Organization
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Legal Business Name | TOWN SURGERY NY PLLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 96 TERRYVILLE RD
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-1388
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Country | US
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Telephone | 631-815-2366
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Fax | 646-774-0936
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Provider Business Mailing Address
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Address Line | 96 TERRYVILLE RD
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-1388
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Country | US
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Telephone | 631-815-2366
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Fax | 646-774-0936
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Authorized Official
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Title or Position | CEO
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Name | DR. ADAM JACE NADELSON
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Credential | MD
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Telephone | 212-500-2163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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