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JOHN T. MATHER MEMORIAL HOSPITAL
NPI 1417044066
Nurse Practitioner - Family in Port Jefferson, NY

Active since October 06, 2006
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320(631) 686-7972 Get Directions Write a Review

NPPES record last updated: April 29, 2015. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About John T. Mather Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN T. MATHER MEMORIAL HOSPITAL (NPI 1417044066) is a healthcare organization registered as a family in Port Jefferson, New York and active in the NPI registry since October 2006. The organization lists Joseph Wisnoski, Vice President Finance, as its authorized official.

NPPES Registry Identity

NPI1417044066
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameJOHN T. MATHER MEMORIAL HOSPITAL
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119
Mailing Address625 Belle Terre Rd, Suite 100Port Jefferson, NY 11777-2316 · (631) 473-1320 · Fax (631) 686-7972
Phone(631) 473-1320
Fax(631) 686-7972
Organization SubpartNo
Authorized OfficialJoseph WisnoskiVice President Finance · (631) 473-1320
Enumeration DateOctober 6, 2006
Last NPPES UpdateApril 29, 2015
✔ NPI 1417044066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
75 N COUNTRY RD, Port Jefferson, NY 11777
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Other Identifiers 1

Medicare ID-Type UnspecifiedW86951NY · Pain Mgmt Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA CATHERINE MELLONE DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
AAKAASH VARMA MD
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KRISELA VOJNIKU MD
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
LORETTA DIDWELL
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
RAYMOND WONG
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-7654
KATLYN ANN CONVILLE ANTHONY NP
Nurse Practitioner (Family)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2565
SHEHNAZ WASIM MD
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-1443
JULIA KOROBENKO DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John T. Mather Memorial Hospital's NPI number?

The NPI number for John T. Mather Memorial Hospital is 1417044066. It was assigned to this organization in the NPPES registry on October 6, 2006.

Where is John T. Mather Memorial Hospital located?

John T. Mather Memorial Hospital is located at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is John T. Mather Memorial Hospital's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for John T. Mather Memorial Hospital was last updated on April 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.