Brookhaven Memorial Hospital
Organization Active NPI Clinic/Center · Patchogue, NY
NPI 1043369721 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1043369721
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- F300787 (NY)
- Legal business name
- BROOKHAVEN MEMORIAL HOSPITAL
- Practice address
- 101 Hospital Rd
Patchogue, NY 11772-4870 - Phone
- (631) 687-4001
- Fax
- (631) 687-4004
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Anthony Shallash, M.D.
- Title
- Chief Medical Officer
- Phone
- (631) 654-7481
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Brookhaven Hospital PA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | F300787 | NY | Yes |
Addresses
Primary practice location
101 Hospital Rd
Patchogue, NY 11772-4870
Mailing address
101 Hospital Rd
Patchogue, NY 11772-4870
Phone (631) 687-4001
NPI Registry JSON
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1043369721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HOSPITAL RD",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117724870",
"telephone_number": "631-687-4001",
"fax_number": "631-687-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HOSPITAL RD",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117724870",
"telephone_number": "631-687-4001",
"fax_number": "631-687-4004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BROOKHAVEN MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SHALLASH",
"authorized_official_first_name": "ANTHONY",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "631-654-7481",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NY",
"license": "F300787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
- Brookhaven Cardiac LLC
- Brookhaven Family Medicine
- Brookhaven Heart PLLC
- Brookhaven Mem Hosp-Nuc C
- Brookhaven Memorial Hosp Psych
- Brookhaven Memorial Hospital
- Brookhaven Memorial Hospital Medical Center
- Brookhaven Memorial Hospital Medical Center
- Brookhaven Memorial Hospital Medical Center
- Brookhaven Memorial Hospital Medical Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.