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General NPI Number Information
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NPI Number | 1386649804
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Entity Type | Organization
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Legal Business Name | CENTRAL SUFFOLK HOSPITAL
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 1300 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2031
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Country | US
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Telephone | 631-548-6000
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Fax | 631-548-6007
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Provider Business Mailing Address
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Address Line | 1300 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2031
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Country | US
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Telephone | 631-548-6000
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Fax | 631-548-6007
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT & CFO
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Name | MRS. MICHELE L CUSACK
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Credential |
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Telephone | 516-321-6508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 5155000H
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License Number State | NY
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