BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER (NPI# 1114141298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114141298 |
| Entity Type | Organization |
| Organization Name | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER |
| Other Organization Name | BROOKHAVEN MEMORIAL HOSPITAL HEALTH CENTER WEST |
| Practice Address |
365 East Main Street Patchogue NY 11772-3145 |
| Mailing Address |
101 Hospital Road Patchogue NY 11772-4870 |
| Practice Telephone | 6318662030 |
| Practice Fax Number | 6316871830 |
| Mailing Telephone | 6316547100 |
| Mailing Fax Number | 5163331075 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-05-12 |
| Authorized Official Name | BRENDA J FARRELL (VICE PRESIDENT & CFO) |
| Authorized Official Telephone | 6316547175 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00245529 | 05 |
| Other Name | Type Code |
|---|---|
| Brookhaven Memorial Hospital Health Center West | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639121825 | Brookhaven Memorial Hospital Medical Center | Emergency Medicine | 101 Hospital Road, Patchogue, NY 11772-4870 | 2006-05-16 |
| 1609877364 | Brookhaven Memorial Hospital Medical Center | Hospice Care, Community Based | 105 West Main Street, Patchogue, NY 11772-3003 | 2005-08-03 |
| 1184041899 | Brookhaven Memorial Hospital Medical Center | Family Medicine | 515 Bellport Ave, Bellport, NY 11713-1711 | 2014-03-20 |
| 1679811293 | Brookhaven Memorial Hospital Medical Center | Clinic/Center | 350 Martha Ave, Bellport, NY 11713-1525 | 2013-01-17 |
| 1114277449 | Brookhaven Memorial Hospital Medical Center | General Acute Care Hospital | 100 Hospital Rd, Patchogue, NY 11772 | 2012-09-13 |
| 1508003716 | Brookhaven Memorial Hospital Medical Center | General Acute Care Hospital | 33 Medford Avenue, Suite D, Patchogue, NY 11772-1222 | 2009-01-09 |
| 1598945735 | Brookhaven Memorial Hospital Medical Center | Clinic/Center | 33 Medford Avenue, Suite D, Patchogue, NY 11772-1222 | 2007-11-05 |
| 1346429115 | Brookhaven Memorial Hospital Medical Center | Psychiatry & Neurology | 101 Hospital Road, Patchogue, NY 11772-4870 | 2007-10-30 |
| 1902029796 | Brookhaven Memorial Hospital Medical Center | Clinic/Center | 550 Montauk Highway, Shirley, NY 11967-2114 | 2007-04-10 |
| 1235210931 | Brookhaven Memorial Hospital Medical Center | Clinic/Center | 101 Hospital Road, Patchogue, NY 11772-4870 | 2006-10-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC. | 101 Hospital Rd., Patchogue, New York 11772 |
| Street Address |
365 EAST MAIN STREET |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649289869 | Mei Yuk Kee | Pediatrics | 365 East Main Street, Patchogue, NY 11772 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306674 | Therapeutic Sanctuary Counseling & Play Therapy Center | Clinic/Center | 3960 Harlem Rd Ste 13, Amherst, NY 14226-4746 | 2020-11-08 |
| 1093316564 | Access Mental Health Counseling, Pllc | Clinic/Center | 10 James Ave, East Norwich, NY 11732-1219 | 2020-11-02 |
| 1700487378 | Listening Ear Counseling and Therapy | Clinic/Center | 36 Watergate Dr, Amawalk, NY 10501-1107 | 2020-11-02 |
| 1154929123 | Culture of Wellness, LLC | Clinic/Center | 31 W 34th St # 7058, New York, NY 10001-3009 | 2020-10-13 |
| 1942807276 | Jason Diana Lmsw | Clinic/Center | 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 | 2020-10-09 |
| 1801493366 | Child and Family Psychological Services | Clinic/Center | 521 Route 111 Ste 202, Hauppauge, NY 11788-4358 | 2020-10-07 |
| 1962015248 | Melissa Gottlieb | Clinic/Center | 285 Livingston St Fl 1, Brooklyn, NY 11217-1006 | 2020-08-26 |
| 1235749409 | Wong Thies Psychology, Pllc | Clinic/Center | 11050 71st Rd Ste 1m, Forest Hills, NY 11375-4972 | 2020-08-03 |
| 1316557606 | Calm Mind Psychiatric Np Services of The Finger Lakes Pllc | Clinic/Center | 840 Hanshaw Rd Ste 9, Ithaca, NY 14850-1589 | 2020-08-03 |
| 1023626678 | Ra Psychiatric Np Services Pllc | Clinic/Center | 2722 Hering Ave, Bronx, NY 10469-5321 | 2020-07-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER.
| 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.