Peconic Endocrinology, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

280046 Issued in NY

Legal business name

PECONIC ENDOCRINOLOGY, PC

Practice address

234 Hampton Rd
Southampton, NY 11968-5028

Phone

(631) 369-8539

Fax

(631) 369-5613

NPI assigned

Mar 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Barbara Gredysa, MD

Title

President

Phone

(631) 369-8539

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1396106860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 HAMPTON RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685028",
            "telephone_number": "631-369-8539",
            "fax_number": "631-369-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 HAMPTON RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685028",
            "telephone_number": "631-369-8539",
            "fax_number": "631-369-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECONIC ENDOCRINOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "GREDYSA",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-369-8539",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "280046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne I Pastore, MD
• Amil A Patel, M.D.
• Reepa Patel
• Shobha R Patel, M.D.
• Alexandra Peck
• Peconic Gastroenterology PC
• Peconic Rnfa Associates, LLP
• Steven Penn, LCSW
• Nadine Persheff, M.D.
• Sophia K Pham, D.O.

• Endocrinology, Diabetes & Metabolism Physician in Southampton, NY
• Providers in Southampton, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.