CENTRAL SUFFOLK HOSPITAL (NPI# 1710901160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710901160 |
Entity Type | Organization |
Organization Name | CENTRAL SUFFOLK HOSPITAL |
Other Organization Name | PECONIC BAY MEDICAL CENTER |
Practice Address |
1300 Roanoke Ave Riverhead NY 11901-2031 |
Practice Telephone | 6315486000 |
Mailing Telephone | 6315486000 |
Enumeration Date | 2006-07-27 |
Last Update Date | 2008-04-20 |
Authorized Official Name | MR. MICHAEL O'DONNELL (SENIOR VP FOR FINACE AND CFO) |
Authorized Official Telephone | 6315486060 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
5155000N | NY | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | BLUE CROSS DIALYSIS | 005225 | 01 |
NY | 00274328 | 05 |
Other Name | Type Code |
---|---|
Peconic Bay Medical Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386649804 | Central Suffolk Hospital | General Acute Care Hospital | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2005-06-21 |
1043402050 | Central Suffolk Hospital | Physician Assistant | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2007-08-14 |
1114973856 | Central Suffolk Hospital | Skilled Nursing Facility | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2006-05-25 |
1932155678 | Central Suffolk Hospital | Home Health | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2006-05-25 |
Entity Type | Entity Name | Entity Address |
---|---|---|
New York State Corporations | CENTRAL SUFFOLK HOSPITAL | Attention: President, 1300 Roanoke Avenue, Riverhead, New York 11901 |
Street Address |
1300 ROANOKE AVE |
City | RIVERHEAD |
State | NY |
Zip Code | 11901-2031 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386649804 | Central Suffolk Hospital | General Acute Care Hospital | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2005-06-21 |
1427655653 | Karina Milagros Alvarez | Registered Nurse | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-10-01 |
1598380735 | Michael Robert Cespites Jr. | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-13 |
1124643747 | Ariane Osterwald | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-09 |
1972127306 | Carolyn Alvarez | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-01 |
1457974172 | Sana Hassan | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-28 |
1407479314 | Chana Stern | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-26 |
1821611096 | Adrienne Clarke | Nurse Anesthetist, Certified Registered | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-05-22 |
1982227112 | Isaac Lee | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-21 |
1598386120 | Mahrukh Riaz | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-05-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578102786 | Michael Arthur Frangeskos | Physician Assistant | 1330 Roanoke Avenue, Riverhead, NY 11901 | 2020-01-06 |
1922569136 | Mjd Optical Corp | Optometrist | 1053 Route 58 Roanoke Ave, Riverhead, NY 11901 | 2019-03-29 |
1356837702 | Justin M Liu | Physician Assistant | 31 Main Rd Ste 3, Riverhead, NY 11901 | 2018-07-09 |
1467943522 | North Shore Hematology Oncology Associates PC | Clinic/Center | 750 Old Country Rd Bldg 2, Riverhead, NY 11901 | 2018-05-24 |
1063918688 | Riverhead Volunteer Ambulance Corps Inc | Ambulance | 111 Osborn Ave, Riverhead, NY 11901 | 2018-04-03 |
1669977906 | Joseph Cataldo | Student in an Organized Health Care Education/Training Program | 64 Ida Lane, Riverhead, NY 11901 | 2018-03-28 |
1861903056 | The Flanders Northampton Volunteer Ambulance Company Inc | Ambulance | 641 Flanders Road, Flanders, NY 11901 | 2017-10-16 |
1336676659 | Patricia Ann Leask | Registered Nurse | 300 Center Drive Suite 250, Methadone Clinic Department of Mental Health, Riverhead, NY 11901 | 2017-05-17 |
1922463447 | Diana Williams-burke | Counselor | 550 East Main St Suite 103, Riverhead, NY 11901 | 2015-12-29 |
1699155549 | Twin Forks Optometry, Pllc | Optometrist | 25 Cranberry Street, Riverhead, NY 11901 | 2015-06-05 |
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Taxonomy Code | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
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1629617576 | Knickerbocker Dialysis Inc | Clinic/Center | 1633 Route 202 Ste 120, Pomona, NY 10970-2926 | 2019-12-24 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.