Provider Demographics
NPI:1306048327
Name:GENERAL SURGERY ASSOCIATES LLC
Entity type:Organization
Organization Name:GENERAL SURGERY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-706-0018
Mailing Address - Street 1:226 N BELLE MEAD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3458
Mailing Address - Country:US
Mailing Address - Phone:631-706-0018
Mailing Address - Fax:631-706-0023
Practice Address - Street 1:226 N BELLE MEAD RD
Practice Address - Street 2:SUITE C
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3458
Practice Address - Country:US
Practice Address - Phone:631-706-0018
Practice Address - Fax:631-706-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW85891Medicare PIN