| East End Physician Services Pc | |
|
44210 County Rd. 48 Southold NY 11971 | |
| (631) 765-4150 | |
| (631) 765-4688 |
| Full Name | East End Physician Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 44210 County Rd. 48, Southold, New York |
| Authorized Official Name and Position | Lloyd Douglas Simon (PRESIDENT (CORPORATION)) |
| Authorized Official Contact | 6317654150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East End Physician Services Pc P.o. Box 1341 Southold NY 11971 Ph: (631) 765-4150 | East End Physician Services Pc 44210 County Rd. 48 Southold NY 11971 Ph: (631) 765-4150 |
| NPI Number | 1407191364 |
|---|---|
| Provider Enumeration Date | 12/04/2012 |
| Last Update Date | 06/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407191364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 153210-1 (New York) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | 153210-1 (New York) | Secondary |
Medical House Calls Of The North Fork, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 57190 Main Rd, Southold, NY 11971 Phone: 631-626-1006 Fax: 631-477-6219 | |
Professional Limited Liability Corp. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Ackerly Pond Lane, Southold, NY 11971 Phone: 631-765-1414 Fax: 631-765-1428 |