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

North Country Colorectal Surgery, PC

Organization Surgery Physician · NPI 1417045519

North Country Colorectal Surgery, PC is a Surgery Physician in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
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

41 N Country Rd
Port Jefferson, NY 11777-2160
Phone: (631) 331-4672
Fax: (631) 331-4239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 206665 (NY)

Record details

NPI number1417045519
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maria Basile — Owner · (631) 331-4672
NPI enumeratedOctober 11, 2006
Last updated in NPPESMarch 14, 2008
Mailing address41 N Country Rd, Port Jefferson, NY 11777-2160

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