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General NPI Number Information
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NPI Number | 1457455669
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Entity Type | Organization
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Legal Business Name | SUFFOLK COUNTY DEPT OF HEALTH SERVICES
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 45 W SUFFOLK AVE
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City | CENTRAL ISLIP
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State | NY
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Zip | 11722-2143
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Country | US
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Telephone | 631-853-2710
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 9006 3500 SUNRISE HWY, SUITE 124
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City | GREAT RIVER
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State | NY
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Zip | 11739-9006
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Country | US
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Telephone | 631-854-0000
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Fax | 631-854-0108
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Authorized Official
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Title or Position | COMMISSIONER
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Name | DR. JAMES L TOMARKEN
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Credential | MD, MPH, MBA, MSW
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Telephone | 631-854-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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