John Leo Coulehan, M.D.
Individual provider Active NPI Internal Medicine Physician · Setauket, NY
NPI 1932464005 · NPPES record last updated Jul 5, 2012
Key facts
- NPI
- 1932464005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 184975 (NY)
- Practice address
- 4 Townsend CT
Setauket, NY 11733-1420 - Phone
- (631) 689-6958
- NPI assigned
- Jul 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 184975 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Preventive Medicine Services, Univ Fclty Practice Corp | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 184975 | NY | Yes |
Addresses
Primary practice location
4 Townsend CT
Setauket, NY 11733-1420
Mailing address
4 Townsend CT
Setauket, NY 11733-1420
Phone (631) 689-6958
Other providers in Setauket, NY
- Kathleen Chung
- Complete Chiropractic Rehabilitation PC
- Amanda Connelly
- Alan Stuart Cooper
- Katherine M Coppeto
- Natashia Marie Crump
- Thomas A Csajko
- CVS Albany LLC
- Robert Thomas Danielson
- Rachel B Davis
All providers in Setauket, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.