NPI 1083839617

Eastern Long Island General and Vascular Surgery PC

Organisation Specialist Southampton, NY

Practice location

Address: 335a Meeting House Ln, Southampton, NY 11968-5051
Phone: (631) 287-6570
Fax: (631) 287-6578

Authorised official

Name: Richard J Ricca
Title: Surgeon
Phone: (631) 287-6570

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 143299 (NY)

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Registry record

NPI: 1083839617
Entity type: Organization
NPI issued: 17 Apr 2007
Record last updated: 25 Apr 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.