Surgical Group Prof Corp

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

147879 Issued in NY

Legal business name

SURGICAL GROUP PROF CORP

Practice address

157 Broadway
Amityville, NY 11701-2729

Phone

(631) 598-7757

Fax

(631) 598-7759

NPI assigned

Feb 6, 2009

Organization subpart

No

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

Authorized official

Name

Jeffrey K Nussbaum, M.D.

Title

President

Phone

(631) 598-7757

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vincent Ciampi, PA

  • Emergency Medicine Physician
  • South Huntington, NY
  • NPI 1750312260
  NPD (past)

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1710126271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012729",
            "telephone_number": "631-598-7757",
            "fax_number": "631-598-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012729",
            "telephone_number": "631-598-7757",
            "fax_number": "631-598-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-598-7757",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "147879",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "147879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Rose Stumpp, LMSW
• Elena Borisovna Stybel, DO
• Paula Sueho, NPP
• Jaclyn Joann Sullivan, MA, LMFT
• Sun River Health Inc
• SVS Services Inc
• Sherese Tonette Sweeney, D.D.S.
• Amna Syed
• Nafisa Syed
• Patricia Tague

• Surgery Physician in Amityville, NY
• Providers in Amityville, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.