NPIMap

Organization Active NPI

East End Gastroenterology PLLC

  • Gastroenterology Physician
  • Manorville, NY
National Provider Identifier
1821673286
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
EAST END GASTROENTEROLOGY PLLC
Practice address
287 Wading River Rd
Unit 2
Manorville, NY 11949-3383
Phone
(631) 591-3000
Fax
(631) 591-1734
NPI assigned
Mar 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Authorized official

Name
Dr. Mark J Coronel, MDNPI 1346416963
Title
Physician / Owner
Phone
(631) 591-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X

Addresses

Primary practice location

287 Wading River Rd
Unit 2
Manorville, NY 11949-3383

Mailing address

856 Bryant St
Woodmere, NY 11598-2540
Phone (631) 591-3000

National Provider Directory

National Provider Directory

Locations

496 County Road 111
Ste 2
Manorville, NY 11949

496 County Road 111
Bldg D2
Manorville, NY 11949
Phone (516) 591-3000

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1821673286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 BRYANT ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982540",
            "telephone_number": "631-591-3000",
            "fax_number": "631-591-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 WADING RIVER RD",
            "address_2": "UNIT 2",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493383",
            "telephone_number": "631-591-3000",
            "fax_number": "631-591-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST END GASTROENTEROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "CORONEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "631-591-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.