To Make an Appointment

To make an appointment please call 631.444.4090 or fill out the form below and a representative will get back to you regarding your appointment.

DO NOT fill out the form below if you are seeking Emergency Medical Attention!!

  • For Emergencies during the day call: 631.444.4090

  • For Evenings, Weekends, Holidays call 631.444.1110

  • Or call the Hospital Emergency Room at 631.444.2450

Please complete all fields before submitting request.

Your E-mail Address:
Daytime Phone Number:
Evening Phone Number:
Please select the name of the physician you are requesting to see:
Are you a current patient of this physician? Yes   No
Reason for Appointment: