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General NPI Number Information
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NPI Number | 1437481744
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Entity Type | Organization
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Legal Business Name | SUFFOL PULMONARY AND SLEEP DISORDERS
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 3400 NESCONSET HWY
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3327
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Country | US
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Telephone | 631-675-9393
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Fax | 631-675-9391
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Provider Business Mailing Address
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Address Line | PO BOX 467
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City | CORAM
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State | NY
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Zip | 11727-0467
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Country | US
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Telephone | 631-675-9393
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Fax | 631-675-9391
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMED T SAMEEN
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Credential | MD
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Telephone | 631-675-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 214732
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License Number State | NY
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