Organization Active NPI

Eastern Long Island General and Vascular Surgery PC

  • Specialist
  • Southampton, NY
National Provider Identifier
1083839617
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
143299 Issued in NY
Legal business name
EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC
Practice address
335A Meeting House LN
Southampton, NY 11968-5051
Phone
(631) 287-6570
Fax
(631) 287-6578
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 143299 NY Primary

Addresses

Primary practice location

335A Meeting House LN
Southampton, NY 11968-5051

Mailing address

335A Meeting House LN
Southampton, NY 11968-5051
Phone (631) 287-6570

National Provider Directory

National Provider Directory

Locations

335A Meeting House Ln
Southampton, NY 11968
Phone (516) 427-8608

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1083839617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335A MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685051",
            "telephone_number": "631-287-6570",
            "fax_number": "631-287-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335A MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685051",
            "telephone_number": "631-287-6570",
            "fax_number": "631-287-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "RICCA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "631-287-6570",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "143299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.