Eastern Long Island Surgery PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

193888 Issued in NY

Legal business name

EASTERN LONG ISLAND SURGERY PC

Practice address

365 County Rd 39a
Suite 11
Southampton, NY 11968

Phone

(631) 287-6202

Fax

(631) 287-6213

NPI assigned

Mar 10, 2008

Last updated

Mar 10, 2008By 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

Medhat E Allam, MDNPI 1932108412

Title

Sole Owner

Phone

(631) 287-6202

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Medhat Allam, M.D.

  • Surgery Physician
  • Southampton, NY
  • NPI 1932108412
  Medicare reassignment NPD Authorized official
• Lawrence J Tarasuk, DO

  • Surgery Physician
  • Southampton, NY
  • NPI 1013182591
  Medicare reassignment NPD

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1699945378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 COUNTY RD 39A",
            "address_2": "SUITE 11",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-287-6202",
            "fax_number": "631-287-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 COUNTY RD 39A",
            "address_2": "SUITE 11",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-287-6202",
            "fax_number": "631-287-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN LONG ISLAND SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "ALLAM",
        "authorized_official_first_name": "MEDHAT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "631-287-6202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "193888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East End Kids Psy, SLP, OT & PT Serv. PLLC
• East End Kids Therapy, Inc.
• East End Pain Management, LLC (East End Pain Center)
• East Ends Tooth Ferry Pediatric Dentistry PLLC
• Eastern Long Island General and Vascular Surgery PC
• Eastern Suffolk Urology PC
• Deborah Edelman, LMSW
• Perry Steven Eisman, M.D.
• Susan Maria Elrich, MD
• Ahmed Saleh Erakat, D.O.

• 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 Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.