Brookhaven Family Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BROOKHAVEN FAMILY MEDICINE

Practice address

100 Hospital Road
Patchogue, NY 11772

Phone

(631) 687-6900

Fax

(631) 447-5954

NPI assigned

May 2, 2013

Last updated

May 2, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

BROOKHAVEN FAMILY MEDICINEAs reported in NPPES

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

Authorized official

Name

Mrs. Linda Ellen Milleisen, LCSW-R

Title

Psychotherapist

Phone

(631) 447-3036

Specialties & licenses 1

Addresses

Part of

Brookhaven Physician Services PC

Locations

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1144665340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL ROAD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-447-3036",
            "fax_number": "631-447-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL ROAD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-687-6900",
            "fax_number": "631-447-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKHAVEN FAMILY MEDICINE",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "MILLEISEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "631-447-3036",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Brodsky-Matwey, OTR/L
• Heather B Bromberg
• Brookhaven Anesthesia Associates
• Brookhaven Anesthesia Associates, LLP
• Brookhaven Cardiac LLC
• Brookhaven Heart PLLC
• Brookhaven Mem Hosp-Nuc C
• Brookhaven Memorial Hosp Psych
• Brookhaven Memorial Hospital
• Brookhaven Memorial Hospital

• Clinic/Center in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.