MEDICARE: SUFFOLK NEPHROLOGY CONSULTANTS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508866492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUFFOLK NEPHROLOGY CONSULTANTS PC

Provider Business Mailing Address
First Line	:	2500 ROUTE 347
Second Line	:	BLDG 14A
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2555
Country	:	US
Telephone Number	:	631-689-7000
Fax Number	:	631-689-3016

Provider Business Practice Location Address
First Line	:	2500 ROUTE 347
Second Line	:	BLDG 14A
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2555
Country	:	US
Telephone Number	:	631-689-7000
Fax Number	:	631-689-3016

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EKAMBARAM ILAMATHI
Credential	:	M.D.
Telephone Number	:	631-689-7800

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

1881862092 — DR. CHRISTINE FRANCES BURACZEWSKI DPT
Practice Location Address:

2500 NESCONSET HWY , BUILDING 22B
STONY BROOK, NY
11790-2555

Practice Phone: 631-751-7988
Practice Fax:

1467451120 — DR. MAURY J GREENBERG M.D.
Practice Location Address:

2500 NESCONSET HWY , BLDG 6D
STONY BROOK, NY
11790-2555

Practice Phone: 631-751-5550
Practice Fax:

1912907486 — DR. DIANE HOFFMAN CYMERMAN MD
Practice Location Address:

2500 NESCONSET HWY , 17-A
STONY BROOK, NY
11790-2555

Practice Phone: 631-751-6262
Practice Fax: 631-751-6268

1376544809 — DR. LINDA COCCHIARELLA MD, MSC
Practice Location Address:

2500 NESCONSET HWY , BLDG #16
STONY BROOK, NY
11790-2555

Practice Phone: 631-444-6250
Practice Fax: 631-444-6665

1093707572 — SCOTT BERMAN MD
Practice Location Address:

2500 NESCONSET HWY , BUILDING 12 SUITE 45
STONY BROOK, NY
11790-2555

Practice Phone: 631-675-9010
Practice Fax: 631-675-9009

1023001070 — DR. JAMES ROBERT GRAZIANO D.C.
Practice Location Address:

2500 NESCONSET HWY , BUILDING 12A
STONY BROOK, NY
11790-2555

Practice Phone: 631-877-1789
Practice Fax:

Directions to “SUFFOLK NEPHROLOGY CONSULTANTS PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.