Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John T. Mather Memorial Hospital

Organization Family Nurse Practitioner · NPI 1417044066

John T. Mather Memorial Hospital provides Family Nurse Practitioner services in Port Jefferson, New York. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2119 Not confirmed with CMS for 11 years — call before visiting
Phone: (631) 473-1320
Fax: (631) 686-7972
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1417044066
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Wisnoski — Vice President Finance · (631) 473-1320
NPI enumeratedOctober 6, 2006
Last updated in NPPESApril 29, 2015
Mailing address625 Belle Terre Rd, Suite 100, Port Jefferson, NY 11777-2316

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