| Meeting House Lane Medical Practice Pc | |
|
57 Hampton Rd Suite 201 Southampton NY 11968-4973 | |
| (631) 283-2430 | |
| (631) 283-7496 |
| Full Name | Meeting House Lane Medical Practice Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 57 Hampton Rd, Southampton, New York |
| Authorized Official Name and Position | Fredrick I Weinbaum (PRESIDENT) |
| Authorized Official Contact | 6317268332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meeting House Lane Medical Practice Pc 57 Hampton Rd Suite 201 Southampton NY 11968-4973 Ph: (631) 283-2430 | Meeting House Lane Medical Practice Pc 57 Hampton Rd Suite 201 Southampton NY 11968-4973 Ph: (631) 283-2430 |
| NPI Number | 1902088495 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 11/10/2016 |
| Medicare PECOS PAC ID | 6800972589 |
|---|---|
| Medicare Enrollment ID | O20080326000089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902088495 | NPI | - | NPPES |
| 031402436 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | William A Gilmartin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457454670 PECOS PAC ID: 6305758442 Enrollment ID: I20031105000629 |
| Provider Name | Alan M Gandolfi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497769541 PECOS PAC ID: 5395638274 Enrollment ID: I20040204000867 |
| Provider Name | Darin G Wiggins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043224173 PECOS PAC ID: 1850284746 Enrollment ID: I20040204000906 |
| Provider Name | Michael J Ameres |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003839127 PECOS PAC ID: 9830082619 Enrollment ID: I20040205000353 |
| Provider Name | Daniel S Crough |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699710384 PECOS PAC ID: 1759274541 Enrollment ID: I20040205000413 |
| Provider Name | Lawrence M Barnard |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1932273414 PECOS PAC ID: 1658268883 Enrollment ID: I20040302001356 |
| Provider Name | Carlos Magalhaes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407068042 PECOS PAC ID: 1254221567 Enrollment ID: I20040408000769 |
| Provider Name | Paul D Garson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124034392 PECOS PAC ID: 6002802774 Enrollment ID: I20040420001854 |
| Provider Name | Richard J Ricca |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003887878 PECOS PAC ID: 7719973882 Enrollment ID: I20040423000154 |
| Provider Name | Shobha Md Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225052897 PECOS PAC ID: 6002803772 Enrollment ID: I20040427000182 |
| Provider Name | Joseph F Stowell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356422786 PECOS PAC ID: 8921099409 Enrollment ID: I20040522000123 |
| Provider Name | Daniel M Vanarsdale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235128505 PECOS PAC ID: 2769464874 Enrollment ID: I20040602001642 |
| Provider Name | Julie A Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235205972 PECOS PAC ID: 6800874108 Enrollment ID: I20040713000312 |
| Provider Name | Anne Marie Montijo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891904488 PECOS PAC ID: 8022088053 Enrollment ID: I20040728000450 |
| Provider Name | James A Moore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386704575 PECOS PAC ID: 7012978109 Enrollment ID: I20041021000977 |
| Provider Name | Edna Kapenhas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386627321 PECOS PAC ID: 5092778126 Enrollment ID: I20041109000832 |
| Provider Name | Hema Dalal |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1215963855 PECOS PAC ID: 5799748687 Enrollment ID: I20041111000220 |
| Provider Name | Candace A Cummings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336252782 PECOS PAC ID: 7113975350 Enrollment ID: I20050105000132 |
| Provider Name | Michael Israel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366407009 PECOS PAC ID: 0840238861 Enrollment ID: I20050420000960 |
| Provider Name | George D Keckeisen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619072436 PECOS PAC ID: 1759329725 Enrollment ID: I20050421000493 |
| Provider Name | Heidi J Roppelt |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578588703 PECOS PAC ID: 6709828783 Enrollment ID: I20050601000016 |
| Provider Name | Sang I Pak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689680019 PECOS PAC ID: 3971547373 Enrollment ID: I20050616000521 |
| Provider Name | Charles V Guida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144288143 PECOS PAC ID: 2860422532 Enrollment ID: I20050820000030 |
| Provider Name | Gaylord Hoffert |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447235965 PECOS PAC ID: 6608801329 Enrollment ID: I20050930000809 |
| Provider Name | Howard M Sklarek |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336229558 PECOS PAC ID: 1951328582 Enrollment ID: I20051110000326 |
| Provider Name | William B Kerr |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871681353 PECOS PAC ID: 1658392022 Enrollment ID: I20051213000478 |
| Provider Name | Louise M Collins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891872107 PECOS PAC ID: 6709808280 Enrollment ID: I20051227000524 |
| Provider Name | Lara Desanti-siska |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255349692 PECOS PAC ID: 5395744007 Enrollment ID: I20061206000497 |
| Provider Name | Paula C Montagna |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1053393140 PECOS PAC ID: 9830291889 Enrollment ID: I20070222000568 |
| Provider Name | Elisa Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538283148 PECOS PAC ID: 7214035971 Enrollment ID: I20070605000209 |
| Provider Name | Catherine B O Brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578513107 PECOS PAC ID: 5193817542 Enrollment ID: I20070815000609 |
| Provider Name | Robert A Munkelwitz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578518627 PECOS PAC ID: 8325122633 Enrollment ID: I20080226000347 |
| Provider Name | Sandeep Gandhi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1366538787 PECOS PAC ID: 7517044340 Enrollment ID: I20080404000008 |
| Provider Name | Jeanne F Speir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437101532 PECOS PAC ID: 5890862528 Enrollment ID: I20080923000341 |
| Provider Name | Wayne J Bellucci |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689856999 PECOS PAC ID: 0042388480 Enrollment ID: I20081013000019 |
| Provider Name | Amil A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578741153 PECOS PAC ID: 0244399095 Enrollment ID: I20081107000399 |
| Provider Name | Max Minnerop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437320215 PECOS PAC ID: 6406916766 Enrollment ID: I20081118000004 |
| Provider Name | James A Brady |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1053462937 PECOS PAC ID: 0244221422 Enrollment ID: I20090122000623 |
| Provider Name | Kristen A Forte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528104213 PECOS PAC ID: 9335298868 Enrollment ID: I20090512000617 |
| Provider Name | Alex M Aponte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861568685 PECOS PAC ID: 3072662659 Enrollment ID: I20090602000060 |
| Provider Name | Kristin P Naso |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487640652 PECOS PAC ID: 4587792817 Enrollment ID: I20100507000099 |
| Provider Name | Gabriella Kovi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588619902 PECOS PAC ID: 9234024696 Enrollment ID: I20100513000274 |
| Provider Name | Nikolaos Hatzis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700082500 PECOS PAC ID: 7315139862 Enrollment ID: I20101004000114 |
| Provider Name | Rhett W Silver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417020736 PECOS PAC ID: 6608773528 Enrollment ID: I20101018001181 |
| Provider Name | Damian A Marrese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215032297 PECOS PAC ID: 1951598606 Enrollment ID: I20101208000170 |
| Provider Name | Olga L Mcabee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134385909 PECOS PAC ID: 4486842036 Enrollment ID: I20101223000018 |
| Provider Name | Allison E Van Arsdale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407143894 PECOS PAC ID: 3476721978 Enrollment ID: I20110728000447 |
| Provider Name | Brad A Rahaman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043473424 PECOS PAC ID: 0244400745 Enrollment ID: I20110818000641 |
| Provider Name | Charles G Arcoleo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770659054 PECOS PAC ID: 4981878451 Enrollment ID: I20111118000019 |
| Provider Name | Stephen Shoten |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013918853 PECOS PAC ID: 6002092681 Enrollment ID: I20111206000220 |
| Provider Name | Maura J Jeffrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144517046 PECOS PAC ID: 2466628052 Enrollment ID: I20120103000527 |
| Provider Name | Christopher Koke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386958080 PECOS PAC ID: 1658527577 Enrollment ID: I20120809000036 |
| Provider Name | Michael L Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366774697 PECOS PAC ID: 1557519998 Enrollment ID: I20120910000782 |
| Provider Name | Konstadinos J Spyris |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003115999 PECOS PAC ID: 7517115629 Enrollment ID: I20120914000512 |
| Provider Name | Anna Marie Wellins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972853729 PECOS PAC ID: 7113166000 Enrollment ID: I20130626000207 |
| Provider Name | Steven B Sobey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114201274 PECOS PAC ID: 9133360399 Enrollment ID: I20130731000020 |
| Provider Name | Jason J Argiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942513072 PECOS PAC ID: 9234372871 Enrollment ID: I20130829000007 |
| Provider Name | Nadia Shaukat |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164743134 PECOS PAC ID: 5193969582 Enrollment ID: I20130925000709 |
| Provider Name | David Capone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629385174 PECOS PAC ID: 1557505864 Enrollment ID: I20130926000095 |
| Provider Name | Kristin F Mielenhausen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417398926 PECOS PAC ID: 4688802473 Enrollment ID: I20140125000280 |
| Provider Name | Louis R Spiegel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821230715 PECOS PAC ID: 6406072404 Enrollment ID: I20140729000316 |
| Provider Name | Nancy Keegan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144548942 PECOS PAC ID: 4284951856 Enrollment ID: I20150318002290 |
| Provider Name | Jinny Caldentey |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1871834788 PECOS PAC ID: 5496073462 Enrollment ID: I20150423001585 |
| Provider Name | Jason T Schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467747790 PECOS PAC ID: 3173701091 Enrollment ID: I20150608001547 |
| Provider Name | Biju Lukose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023378049 PECOS PAC ID: 9739492364 Enrollment ID: I20150724011332 |
| Provider Name | Tara Christine Barcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962762062 PECOS PAC ID: 0648584235 Enrollment ID: I20150727001067 |
| Provider Name | Ahsan A Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780979682 PECOS PAC ID: 0840507687 Enrollment ID: I20150911000365 |
| Provider Name | Rachel Jean Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457613978 PECOS PAC ID: 8527364272 Enrollment ID: I20160307002661 |
| Provider Name | Lauryn Florence Korsakas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669867214 PECOS PAC ID: 7113232943 Enrollment ID: I20160606001969 |
| Provider Name | Wahid Rashidzada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346416021 PECOS PAC ID: 0749334738 Enrollment ID: I20160616000445 |
| Provider Name | Gianhna Altagracia Gil Sanchez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194046755 PECOS PAC ID: 1951529452 Enrollment ID: I20160822000761 |
| Provider Name | Edwin Michael Keeshan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649692690 PECOS PAC ID: 9032496203 Enrollment ID: I20170426001789 |
| Provider Name | Sony A Modayil |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1154764298 PECOS PAC ID: 8022383694 Enrollment ID: I20171006002321 |
| Provider Name | Kashif Hussain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154462513 PECOS PAC ID: 1355395062 Enrollment ID: I20171012000042 |
| Provider Name | Lisa Snelling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508378084 PECOS PAC ID: 4880956200 Enrollment ID: I20180323001167 |
| Provider Name | Francesca Mendola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811498470 PECOS PAC ID: 8325395940 Enrollment ID: I20180727000059 |
| Provider Name | Shahzad Chaudhary |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700265030 PECOS PAC ID: 3779835103 Enrollment ID: I20181011002159 |
| Provider Name | Eric Sin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750708749 PECOS PAC ID: 3678806460 Enrollment ID: I20190701001000 |
| Provider Name | Devan Trammel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497141709 PECOS PAC ID: 5890020754 Enrollment ID: I20190715001768 |
| Provider Name | Gaurav Bhardwaj |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760938062 PECOS PAC ID: 7012255730 Enrollment ID: I20190729001853 |
| Provider Name | Angelica Knuppel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1972136976 PECOS PAC ID: 2062842636 Enrollment ID: I20200422001441 |
| Provider Name | Christopher David Liedke |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1982022943 PECOS PAC ID: 1658612726 Enrollment ID: I20200508001443 |
| Provider Name | Joshua F Potter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669835724 PECOS PAC ID: 8628305281 Enrollment ID: I20200512000623 |
| Provider Name | Raj Grover |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811341852 PECOS PAC ID: 7214271444 Enrollment ID: I20200520000581 |
| Provider Name | Brian Boden |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134651250 PECOS PAC ID: 0446671184 Enrollment ID: I20200604000497 |
| Provider Name | Israr Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790219285 PECOS PAC ID: 6507287265 Enrollment ID: I20200604001366 |
| Provider Name | Patrick Rutka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528599099 PECOS PAC ID: 0941621668 Enrollment ID: I20200605000514 |
| Provider Name | Eric M Lella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558716936 PECOS PAC ID: 1557698230 Enrollment ID: I20200619000111 |
| Provider Name | Mia Amanda Laurel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053713271 PECOS PAC ID: 1456688928 Enrollment ID: I20200924001971 |
| Provider Name | Tracey L Joost-morea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528610011 PECOS PAC ID: 6507810165 Enrollment ID: I20201005000584 |
| Provider Name | Sabrina Trammel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679935092 PECOS PAC ID: 3173942489 Enrollment ID: I20201005002601 |
| Provider Name | Keith Zauderer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871949867 PECOS PAC ID: 9537589494 Enrollment ID: I20201014000847 |
| Provider Name | Michelle Annette Wintjen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750868824 PECOS PAC ID: 6406261023 Enrollment ID: I20210212000693 |
| Provider Name | Paul Poidomani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326579830 PECOS PAC ID: 3678973104 Enrollment ID: I20210621001367 |
| Provider Name | Max Victor Macbarb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609371442 PECOS PAC ID: 3779984646 Enrollment ID: I20210629003085 |
| Provider Name | Rachel De Andrade Pereira |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477086619 PECOS PAC ID: 0446654974 Enrollment ID: I20210805002779 |
| Provider Name | Marylen Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053087619 PECOS PAC ID: 2668879669 Enrollment ID: I20210917000968 |
| Provider Name | Dmitriy Generalov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871080911 PECOS PAC ID: 8729468012 Enrollment ID: I20220705000490 |
| Provider Name | Kathryn Allison Saxby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326545245 PECOS PAC ID: 4981084878 Enrollment ID: I20220709000366 |
| Provider Name | Anthony John Vacchio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013477033 PECOS PAC ID: 0446632483 Enrollment ID: I20220808000688 |
| Provider Name | Preethi Kumar |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1205222437 PECOS PAC ID: 7517226566 Enrollment ID: I20220901001441 |
| Provider Name | Brian C Carolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730672429 PECOS PAC ID: 1658748686 Enrollment ID: I20221104000803 |
| Provider Name | Amy Elizabeth Dalton |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1144742917 PECOS PAC ID: 3274902622 Enrollment ID: I20221207002283 |
| Provider Name | Amanda Mackillop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770128753 PECOS PAC ID: 6709257660 Enrollment ID: I20230201000909 |
| Provider Name | Maureen Coley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376606368 PECOS PAC ID: 9638260631 Enrollment ID: I20230208003159 |
| Provider Name | Alexandra Coacci |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1669177218 PECOS PAC ID: 5597125591 Enrollment ID: I20230724000330 |
| Provider Name | Michael Tenore |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225526817 PECOS PAC ID: 8224499256 Enrollment ID: I20230807002296 |
| Provider Name | Christine Elizabeth Abbate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629732680 PECOS PAC ID: 9537522016 Enrollment ID: I20230831000433 |
| Provider Name | Elena Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578975066 PECOS PAC ID: 3375906639 Enrollment ID: I20230905000543 |
| Provider Name | Kristin Theresa Russo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801511837 PECOS PAC ID: 4688011869 Enrollment ID: I20240322004191 |
| Provider Name | Michael Farney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649893918 PECOS PAC ID: 1355760968 Enrollment ID: I20240507002669 |
| Provider Name | Ana Laura Martinez-tapia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225565864 PECOS PAC ID: 3678833415 Enrollment ID: I20240521001819 |
| Provider Name | Lucy Moussignac |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104402643 PECOS PAC ID: 0941749949 Enrollment ID: I20240822000041 |
| Provider Name | Carly Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861173213 PECOS PAC ID: 0345775235 Enrollment ID: I20241202002731 |
| Provider Name | Jennifer Zorko |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497535066 PECOS PAC ID: 3072049857 Enrollment ID: I20241204002420 |
Southampton Immediate Medical Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 290 N Sea Rd, Southampton, NY 11968 Phone: 631-283-5900 Fax: 631-287-7174 | |
The New York Center For Coaching, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Saint Andrews Cir, Southampton, NY 11968 Phone: 631-259-2154 | |
Peconic Endocrinology, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 234 Hampton Rd, Southampton, NY 11968 Phone: 631-369-8539 Fax: 631-369-5613 | |
Michael S Oakley Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 N Main St, Southampton, NY 11968 Phone: 631-204-1361 Fax: 631-204-1367 | |