| Eastern Long Island Family Medicine Pc | |
|
100 S Jersey Ave Suite 14 East Setauket NY 11733-2034 | |
| (631) 751-3883 | |
| (631) 751-3909 |
| Full Name | Eastern Long Island Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 S Jersey Ave, East Setauket, New York |
| Authorized Official Name and Position | Christopher Ng (PRESIDENT) |
| Authorized Official Contact | 6317513883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Long Island Family Medicine Pc 100 S Jersey Ave Suite 14 East Setauket NY 11733-2034 Ph: (631) 751-3883 | Eastern Long Island Family Medicine Pc 100 S Jersey Ave Suite 14 East Setauket NY 11733-2034 Ph: (631) 751-3883 |
| NPI Number | 1003089640 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 10/23/2013 |
| Medicare PECOS PAC ID | 6507779352 |
|---|---|
| Medicare Enrollment ID | O20031111000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003089640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 211195 (New York) | Primary |
| Provider Name | Christopher Ng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134127616 PECOS PAC ID: 3678486420 Enrollment ID: I20040109000878 |
| Provider Name | Catheryne Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164806535 PECOS PAC ID: 3476897588 Enrollment ID: I20181130000357 |
| Provider Name | Judith M Magloczki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801240064 PECOS PAC ID: 2264769868 Enrollment ID: I20200722003191 |
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