PATCHOGUE ORTHODONTICS PC NPI 1598136145

NPI Information

NPI: 1598136145
Provider Name: PATCHOGUE ORTHODONTICS, PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 33D1102361

Address:
240 PATCHOGUE YAPHANK RD
EAST PATCHOGUE, NY
ZIP 11772
Phone: (631) 447-7623
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PATCHOGUE ORTHODONTICS, PC is a dental clinic center in East Patchogue, NY. PATCHOGUE ORTHODONTICS, PC NPI is 1598136145. The provider is registered as an organization entity type.

The provider's business location address is:

240 PATCHOGUE YAPHANK RD
EAST PATCHOGUE, NY
ZIP 11772-868
Phone: (631) 447-7623
Fax: (631) 289-3363

The provider's authorized official is Robert Rubin .
The authorized official title is President and has the following contact phone number (631) 447-7623.

The CLIA number assigned to this NPI record is 33D1102361 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/8/2015 and was last updated on 10/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	38848-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01067647	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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