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General NPI Number Information
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NPI Number | 1740523075
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Entity Type | Organization
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Legal Business Name | ESTHER SUMITRA-ALBERT MD, PLLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 1056 W JERICHO TPKE
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City | SMITHTOWN
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State | NY
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Zip | 11787-3212
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Country | US
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Telephone | 631-343-7600
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Fax | 631-982-1999
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Provider Business Mailing Address
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Address Line | 1056 W JERICHO TPKE
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City | SMITHTOWN
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State | NY
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Zip | 11787-3212
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Country | US
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Telephone | 631-343-7600
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Fax | 631-982-1999
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ESTHER A SUMITRA-ALBERT
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Credential | M.D.
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Telephone | 631-343-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 223344
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License Number State | NY
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