Basic Information
| Provider Information | |||||||||
| NPI: | 1396197927 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUND PHYSICIAN SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 ROUTE 25A STE 225 | ||||||||
| Address2: | |||||||||
| City: | ROCKY POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117788802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317443671 | ||||||||
| FaxNumber: | 6317446205 | ||||||||
| Practice Location | |||||||||
| Address1: | 1174 ROUTE 112 | ||||||||
| Address2: | |||||||||
| City: | PORT JEFFERSON STATION | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117768033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317443671 | ||||||||
| FaxNumber: | 6317446205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2016 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| AuthorizedOfficialLastName: | VON LINTIG | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6317443671 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 204410 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.