NPIMap

Organization Active NPI

Suffolk Interventional Suites Inc.

  • Ambulatory Surgical Clinic/Center
  • Port Jefferson Station, NY
National Provider Identifier
1679716245
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SUFFOLK INTERVENTIONAL SUITES INC.
Practice address
1110B Hallock Avenue
Port Jefferson Station, NY 11776-1210
Phone
(631) 476-9100
NPI assigned
Apr 13, 2009
Last updated
Apr 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Robert M Pollina, MDNPI 1013988088
Title
President
Phone
(631) 476-9100

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
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1110B Hallock Avenue
Port Jefferson Station, NY 11776-1210

Mailing address

1110B Hallock Avenue
Port Jefferson Station, NY 11776-1210
Phone (631) 476-9100

National Provider Directory

National Provider Directory

Locations

1110 Hallock Ave
#B
Port Jefferson Station, NY 11776
Phone (631) 476-9100

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": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1679716245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110B HALLOCK AVENUE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110B HALLOCK AVENUE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK INTERVENTIONAL SUITES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "POLLINA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-476-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.