SUFFOLK NEPHROLOGY CONSULTANTS PC NPI 1508866492

NPI Information

NPI: 1508866492
Provider Name: SUFFOLK NEPHROLOGY CONSULTANTS PC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
2500 ROUTE 347
BLDG 14A
STONY BROOK, NY
ZIP 11790
Phone: (631) 689-7000
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SUFFOLK NEPHROLOGY CONSULTANTS PC is a nephrology internal medicine in Stony Brook, NY. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. SUFFOLK NEPHROLOGY CONSULTANTS PC NPI is 1508866492. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2500 ROUTE 347
BLDG 14A
STONY BROOK, NY
ZIP 11790-555
Phone: (631) 689-7000
Fax: (631) 689-3016

The provider's authorized official is Ekambaram Ilamathi .
The authorized official title is President and has the following contact phone number (631) 689-7800.

The enumeration date for this NPI number is 7/21/2005 and was last updated on 8/22/2020.

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	207RN0300X	Internal Medicine	Nephrology	=========	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	02524330	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: 11/14/2023

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