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Contact Information

MICHAEL SUZZIVALLI
635 BELLE TERRE RD
SUITE #204
PORT JEFFERSON, NY11777-1935
 Phone: 631-474-0008
 Fax: 631-474-0224
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICHAEL SUZZIVALLI · (Male)

NPI # 1194737973
Status Active
Credentials
Entity Individual
Enumeration date 08/12/2006
Last updated 01/27/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 008264
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
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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