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

Nassau Suffolk Medical Practice, PC

Organization Family Medicine Physician · NPI 1417998352

Nassau Suffolk Medical Practice, PC is a Family Medicine Physician 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
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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