SAGAPONACK MEDICAL PC (NPI# 1407351646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407351646 |
| Entity Type | Organization |
| Organization Name | SAGAPONACK MEDICAL PC |
| Practice Address |
3350 Noyack Rd Sag Harbor NY 11963 |
| Mailing Address |
3350 Noyac Rd Sag Harbor NY 11963-1908 |
| Practice Telephone | 6317311099 |
| Mailing Telephone | 6317311099 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2019-08-02 |
| Authorized Official Name | DR. MARK A. HALSEY (PRESIDENT) |
| Authorized Official Telephone | 6317311099 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3350 Noyack Rd, Sag Harbor, NY 11963 | 6317311099 | |
| 686 County Road 39a, Southampton, NY 119685703 | 8134131223 |
| Street Address |
3350 NOYACK RD |
| City | SAG HARBOR |
| State | NY |
| Zip Code | 11963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549807 | Twentyseveneastphysiotherapy PC | Physical Therapist | 34 Bay Street, Suite 206, Sag Harbor, NY 11963 | 2020-02-10 |
| 1821331604 | Diana Immenhausen | Family Medicine | 3330 Noyac Road Burkeshire Court, Bldg A, Sag Harbor, NY 11963 | 2013-03-31 |
| 1386849651 | Kimberlee A Sherman | Registered Nurse | 1155 Bridghampton Turnpike, Bridgehampton, NY 11963 | 2007-06-18 |
| 1720280316 | Glenn Neal Goodman | Chiropractor | 3334 Noyac Road, Sag Harbor, NY 11963 | 2007-06-05 |
| 1811198203 | Jaime Lynn Kosinski | Speech-Language Pathologist | 22 Oak Drive, North Haven, Sag Harbor, NY 11963 | 2007-05-31 |
| 1942425798 | Victoria L Sharp | Internal Medicine | 11 Ninevah Pl, Sag Harbor, NY 11963 | 2007-04-16 |
| 1356462618 | Tod Reed Granger | Dentist | 3330 Noyac Road, Bldg B, Sag Harbor, NY 11963 | 2007-04-03 |
| 1841325628 | Suzanne Jayne Kirby | Chiropractor | 3334 Noyac Rd, Sag Harbor, NY 11963 | 2007-02-22 |
| 1427194745 | Sag Harbor Ufsd | Local Education Agency (LEA) | 200 Jermain Avenue, Sag Harbor, NY 11963 | 2007-01-30 |
| 1710045208 | Stephen James Petruccelli | Chiropractor | 39 Division Street, Sag Harbor, NY 11963 | 2006-12-05 |
| Find all providers in zip 11963 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1598259996 | Ds Medical Diagnostics PC | Clinic/Center | 13249 41st Rd Ste 1c, Flushing, NY 11355-4286 | 2018-06-19 |
| Find all providers with the same taxonomy | ||||
| City | SAG HARBOR |
| Zip Code | 11963 |
Please comment or provide details below to improve the information on SAGAPONACK MEDICAL PC.
| 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.