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General NPI Number Information
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NPI Number | 1962770602
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Entity Type | Organization
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Legal Business Name | SOUTHAMPTON HOSPITAL
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 74 OLD RIVERHEAD RD
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978-1401
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Country | US
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Telephone | 631-288-7767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1613
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City | SOUTHAMPTON
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State | NY
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Zip | 11969-1613
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Country | US
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Telephone | 631-726-8514
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | LAUREN ELIZABETH STOEBE
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Credential | P.T./D.P.T.
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Telephone | 631-726-8514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 0344081
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License Number State | NY
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