Provider Demographics
NPI:1225762503
Name:TOWN SURGERY NY PLLC
Entity type:Organization
Organization Name:TOWN SURGERY NY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JACE
Authorized Official - Last Name:NADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-500-2163
Mailing Address - Street 1:96 TERRYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1388
Mailing Address - Country:US
Mailing Address - Phone:631-815-2366
Mailing Address - Fax:646-774-0936
Practice Address - Street 1:96 TERRYVILLE RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1388
Practice Address - Country:US
Practice Address - Phone:631-815-2366
Practice Address - Fax:646-774-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty