NPIMap

Organization Active NPI

North Suffolk Surgical Assoc

  • Specialist
  • Port Jefferson, NY
National Provider Identifier
1447414370
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
133133 Issued in NY
Legal business name
NORTH SUFFOLK SURGICAL ASSOC
Practice address
625 Belle Terre Rd
Suite 201
Port Jefferson, NY 11777-2316
Phone
(631) 474-0707
Fax
(631) 474-4034
NPI assigned
Jul 10, 2008
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Dr. Edward Borden, M.D.NPI 1316966245
Title
President
Phone
(631) 474-0707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 133133 NY Primary

Addresses

Primary practice location

625 Belle Terre Rd
Suite 201
Port Jefferson, NY 11777-2316

Mailing address

333 Route 25a
Rocky Point, NY 11778-8556
Phone (631) 474-0707

National Provider Directory

National Provider Directory

Locations

625 Belle Terre Rd
Ste 201
Prt Jefferson, NY 11777

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1447414370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ROUTE 25A",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788556",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BELLE TERRE RD",
            "address_2": "SUITE 201",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772316",
            "telephone_number": "631-474-0707",
            "fax_number": "631-474-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUFFOLK SURGICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "BORDEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-474-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "133133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.