Cutchogue Internal Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

224524 Issued in NY

Legal business name

CUTCHOGUE INTERNAL MEDICINE, PLLC

Practice address

32645 Main Rd
Cutchogue, NY 11935-1364

Phone

(631) 734-7670

Fax

(631) 734-7670

NPI assigned

Sep 8, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Impellizeri, D.O.NPI 1669466363

Title

Manging Member

Phone

(631) 734-7670

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Impellizeri, D.O

  • Internal Medicine Physician
  • Mattituck, NY
  • NPI 1669466363
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003800715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1159",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119350874",
            "telephone_number": "631-734-7670",
            "fax_number": "631-734-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32645 MAIN RD",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119351364",
            "telephone_number": "631-734-7670",
            "fax_number": "631-734-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUTCHOGUE INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IMPELLIZERI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANGING MEMBER",
        "authorized_official_telephone_number": "631-734-7670",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "224524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02444824",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Corbley, MAED
• Jessica Cosgrove, D.O.
• Michael Crosser, M.D.
• Cutchogue Barths Pharmacy Inc
• Cutchogue Drug Store
• Cutchogue Walk-in Medical Care PLLC
• Scott Z Czujko, DPT
• Laura Lee Davis
• Lorraine Dibble, P.T.
• Diana Falkenbach, PH.D.

• Internal Medicine Physician in Cutchogue, NY
• Providers in Cutchogue, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.