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EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC NPI 1083839617


NPI Information

NPI: 1083839617
Provider Name: EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
335A MEETING HOUSE LN
SOUTHAMPTON, NY
ZIP 11968
Phone: (631) 287-6570
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EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC is a specialist in Southampton, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC NPI is 1083839617. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

335A MEETING HOUSE LN
SOUTHAMPTON, NY
ZIP 11968-051
Phone: (631) 287-6570
Fax: (631) 287-6578

The provider's authorized official is Richard J Ricca .
The authorized official title is Surgeon and has the following contact phone number (631) 287-6570.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 4/25/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist143299NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WCL711MEDICARE PINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.