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General NPI Number Information
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NPI Number | 1871869305
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Entity Type | Organization
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Legal Business Name | SUFFOLK ANESTHESIA SERVICES PLLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 471 MONTAUK HWY
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City | WEST ISLIP
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State | NY
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Zip | 11795-4414
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Country | US
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Telephone | 631-849-1050
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Fax | 631-849-1052
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Provider Business Mailing Address
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Address Line | PO BOX 2448
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City | LEXINGTON
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State | SC
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Zip | 29071-2448
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Country | US
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Telephone | 631-849-1050
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Fax | 803-520-4125
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Authorized Official
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Title or Position | PARTNER
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Name | BRIAN COOK
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Credential | MD
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Telephone | 631-849-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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