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Contact Information

JOHN A IPPOLITO, DO
100 S JERSEY AVE
UNIT 19
SETAUKET, NY11733-2034
 Phone: 631-689-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rheumatology

207RR0500X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JOHN A IPPOLITO · (Male)

NPI # 1043275605
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/18/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 167286
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
  • PECONIC BAY MEDICAL CENTER - (Acute Care)
    1300 ROANOKE AVENUE
    RIVERHEAD, NY 11901
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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