East End Plastic, Reconstructive & Hand Surgery, P.C.

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

206403 Issued in NY

Legal business name

EAST END PLASTIC, RECONSTRUCTIVE & HAND SURGERY, P.C.

Practice address

1267 E Main St
Riverhead, NY 11901-2673

Phone

(631) 369-0490

Fax

(631) 369-6421

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Judy Ann Emanuele, M.D.

Title

Physician

Phone

(631) 369-0490

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255359600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012673",
            "telephone_number": "631-369-0490",
            "fax_number": "631-369-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012673",
            "telephone_number": "631-369-0490",
            "fax_number": "631-369-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST END PLASTIC, RECONSTRUCTIVE & HAND SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EMANUELE",
        "authorized_official_first_name": "JUDY ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-369-0490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "206403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA INS. PROVIDER ID #",
            "identifier": "2127965",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP ID #",
            "identifier": "206403-8",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE INS. #",
            "identifier": "2364740",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY INSURANCE PROVIDER #",
            "identifier": "AA72815",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INS. PROVIDER ID #",
            "identifier": "P831475",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery of the Hand (Plastic Surgery) Physician in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Surgery of the Hand (Plastic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.