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

Nassau Suffolk Medical Practice, PC

Organization Family Medicine Physician · NPI 1417998352

Nassau Suffolk Medical Practice, PC provides Family Medicine Physician services in West Babylon, New York. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

120 Route 109
West Babylon, NY 11704-6210 Not confirmed with CMS for 17 years — call before visiting
Phone: (631) 422-3636
Fax: (631) 422-2788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1417998352
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ani Bodoutchian — Owner · (631) 422-3636
NPI enumeratedJune 10, 2006
Last updated in NPPESAugust 26, 2009
Mailing address120 Route 109, West Babylon, NY 11704-6210

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