BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER


Address: 550 Montauk Highway, Shirley, NY 11967-2114
Phone: 6314903040

BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER (NPI# 1902029796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902029796
Entity Type Organization
Organization Name BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER
Other Organization Name BROOKHAVEN MEMORIAL HOSPITAL HEALTH CENTER EAST
Practice Address 550 Montauk Highway
Shirley
NY 11967-2114
Mailing Address 101 Hospital Road
Patchogue
NY 11772-4870
Practice Telephone 6314903040
Practice Fax Number 6313956340
Mailing Telephone 6316547100
Mailing Fax Number 5163331075
Enumeration Date 2007-04-10
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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NY 00245529 05

Other Provider/Organization Names

Other Name Type Code
Brookhaven Memorial Hospital Health Center East Other Name - Individual/Organization

Other Provider IDs and Locations

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
1114141298 Brookhaven Memorial Hospital Medical Center Clinic/Center 365 East Main Street, Patchogue, NY 11772-3145 2007-04-12
1235210931 Brookhaven Memorial Hospital Medical Center Clinic/Center 101 Hospital Road, Patchogue, NY 11772-4870 2006-10-18

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC. 101 Hospital Rd., Patchogue, New York 11772

Office Location

Street Address 550 MONTAUK HIGHWAY
City SHIRLEY
State NY
Zip Code 11967-2114

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891704011 Anjumon A Amin Pediatrics 550 Montauk Highway, Shirley, NY 11967 2006-08-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588149744 Dawn Kirby Licensed Practical Nurse 8 Crestwood Drive, Shirley, NY 11967 2018-10-03
1538684451 Crystal E Gambles Licensed Practical Nurse 502 Wellwood Drive, Shirley, NY 11967 2017-08-11
1003330887 Aura Blum Care, Inc Licensed Practical Nurse 436 Auborn Av, Shirley, NY 11967 2017-08-02
1891239687 Holly Scott-rodriguez Behavior Technician 57 Probst Drive, Shirley, NY 11967 2016-12-13
1487106357 Joann C Duran Licensed Practical Nurse 320 Decatur Avenue, East Yaphank, NY 11967 2016-10-26
1053776815 Andrea Janet Murphy-hamilton Registered Nurse 369 Puritan Dr., N Shirley, NY 11967 2015-12-22
1588039598 Thomas B Maher Student in an Organized Health Care Education/Training Program 483 West End Ave., Shirley, NY 11967 2015-12-02
1346676707 Sharon Marie Dougherty Social Worker 1250 William Floyd Parkway, Shirley, NY 11967 2013-09-17
1083964241 Charlotte Dametra Fleming Licensed Practical Nurse 420 Lakepointe Drive, Middleisland, NY 11967 2012-09-14
1982954277 Sefika Dimaggio Registered Nurse 32 Candido Ave, Shirley, NY 11967 2012-09-13
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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1700487378 Listening Ear Counseling and Therapy Clinic/Center 36 Watergate Dr, Amawalk, NY 10501-1107 2020-11-02
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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
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Competitor

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City SHIRLEY
Zip Code 11967

Improve Information

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Dataset Information

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.

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