Islandwide Thoracic Surgery, PLLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

ISLANDWIDE THORACIC SURGERY, PLLC

Practice address

1500 Route 112 Ste B
Port Jefferson Station, NY 11776-8055

Phone

(631) 353-0909

NPI assigned

Jun 1, 2023

Organization subpart

No

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

Authorized official

Name

Gregory Brevetti, MD

Title

Owner/ Provider

Phone

(917) 575-8907

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1396438594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-353-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLANDWIDE THORACIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "BREVETTI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "917-575-8907",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Medical Professionals PLLC
• Integrative Medicine of Brookhaven P.C.
• Integrative Neurology, P.C.
• Is Radiology PLLC
• Island Psychiatry, P.C.
• Arelys Itwaru, PMHNP-BC
• Hamid Jabbary, DDS
• Regina L Jablonski, MD
• Robert A Jacobs, M.D.
• James E. Carlson D.O., P.C.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.