Mbody Minimally Invasive Surgery, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

200259 Issued in NY

Legal business name

MBODY MINIMALLY INVASIVE SURGERY, PC

Practice address

365 County Road 39a
Suite 11
Southampton, NY 11968-5284

Phone

(631) 591-3992

Fax

(631) 591-0206

NPI assigned

Oct 22, 2010

Last updated

Nov 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nick H Gabriel, D.O.

Title

C.E.O. - Managing Partner

Phone

(631) 591-3992

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1275833477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 COUNTY ROAD 39A",
            "address_2": "SUITE 11",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685284",
            "telephone_number": "631-591-3992",
            "fax_number": "631-591-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 COUNTY ROAD 39A",
            "address_2": "SUITE 11",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685284",
            "telephone_number": "631-591-3992",
            "fax_number": "631-591-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBODY MINIMALLY INVASIVE SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "NICK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "C.E.O. - MANAGING PARTNER",
        "authorized_official_telephone_number": "631-591-3992",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "200259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Louise Massarotti, DPT
• Thomas Mathew, M.D.
• Matthew McDavid LCSW PLLC (McDavid Creative Therapy)
• Lauren Debra Matzen, MAC,LICAC,NCCAOM DIP
• Jo Anne Maynard, DNP
• Olga L McAbee, MD
• Elaine Mary McCarthy, PA
• Christopher Joseph McCord, PA
• Matthew Collins McDavid, LCSW
• Margaret McDonald, R.N.

• Surgery Physician in Southampton, NY
• Providers in Southampton, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.