PORT JEFFERSON OBGYN PC (NPI# 1073689477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073689477 |
| Entity Type | Organization |
| Organization Name | PORT JEFFERSON OBGYN PC |
| Practice Address |
640 Belle Terre Road Bldg D Port Jefferson NY 11777-1936 |
| Practice Telephone | 6319280720 |
| Practice Fax Number | 6319288620 |
| Mailing Telephone | 6319280720 |
| Mailing Fax Number | 6319288620 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PHILIP J MAKOWSKI (PARTNER) |
| Authorized Official Telephone | 6319280720 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
640 BELLE TERRE ROAD BLDG D |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-1936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366514978 | Robert Michael Woznicki | Psychiatry & Neurology | 640 Belle Terre Road, Bldg J 3, Port Jefferson, NY 11777 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922084383 | Mindy Lynn Shaffran | Obstetrics & Gynecology | 118 North Country Road, Port Jefferson, NY 11777 | 2005-12-19 |
| 1255315461 | Amy Renee Richter | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-01 |
| 1629206156 | Sarah R Karalitzky | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2009-06-23 |
| 1982790192 | Suffolk Obgyn LLP | Obstetrics & Gynecology | 118 North Country Road, Port Jefferson, NY 11777 | 2006-10-05 |
| 1952387649 | Gerardo Alfredo Sanroman | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-15 |
| 1720062375 | Douglas Sheldon Lee | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-06 |
| 1497739064 | John Gregg Petraco | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-06 |
| 1508840711 | Dennis Stephen Strittmatter | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-01 |
| 1871577080 | Paul Louis Lograno | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-01 |
| 1750365912 | Jennifer Dale Marshak | Obstetrics & Gynecology | 118 N Country Rd, Port Jefferson, NY 11777-2120 | 2005-12-01 |
| Find all providers in PORT JEFFERSON | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.