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General NPI Number Information
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NPI Number | 1275447716
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN UNIVERSITY HOSPITAL- ST. CHARLES CAMPUS
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 200 BELLE TERRE RD
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1928
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Country | US
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Telephone | 631-474-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95000-6540
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City | PHILADELPHIA
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State | PA
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Zip | 19195-0001
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Country | US
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Telephone | 631-465-6121
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Fax |
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Authorized Official
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Title or Position | VP, PHYSICIAN ENTERPRISE FINANCIAL
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Name | LORRAINE HUMMEL
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Credential |
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Telephone | 631-465-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | NULL
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