NPIMap

Organization Active NPI

Peconic Ear Nose Throat & Facial Plastic Surgery, PC

  • Specialist
  • Aquebogue, NY
National Provider Identifier
1841483633
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, PC
Practice address
292 Shade Tree Lane
Aquebogue, NY 11931
Phone
(631) 727-8050
Fax
(631) 727-8110
NPI assigned
Aug 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Kevin Braat, MDNPI 1871595462
Title
President
Phone
(631) 727-8050

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

292 Shade Tree Lane
Aquebogue, NY 11931

Mailing address

292 Shade Tree Lane
PO Box 2668
Aquebogue, NY 11931
Phone (631) 727-8050

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1841483633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 SHADE TREE LANE",
            "address_2": "PO BOX 2668",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "11931",
            "telephone_number": "631-727-8050",
            "fax_number": "631-727-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 SHADE TREE LANE",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "11931",
            "telephone_number": "631-727-8050",
            "fax_number": "631-727-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "BRAAT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-727-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aquebogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.