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General NPI Number Information
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NPI Number | 1669795563
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Entity Type | Organization
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Legal Business Name | SUFFOLK PULMONARY ASSOCIATES, LLP
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 60 N COUNTRY RD SUITE 203
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2188
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Country | US
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Telephone | 631-509-1888
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Fax | 877-434-7939
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Provider Business Mailing Address
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Address Line | 60 N COUNTRY RD SUITE 203
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2188
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Country | US
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Telephone | 631-509-1888
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Fax | 877-434-7939
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAY M BARBAKOFF
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Credential | M.D.
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Telephone | 631-509-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 165292
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License Number State | NY
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