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Contact Information

PECONIC GASTROENTEROLOGY PC
223 HAMPTON RD
SOUTHAMPTON, NY11968-5027
 Phone: 631-283-0090
 Fax: 631-287-1037
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for PECONIC GASTROENTEROLOGY PC · (Female)

NPI Number 1740276898
Status Active
Credentials
Entity Individual
Enumeration date 09/23/2005
Last updated 01/06/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY Medicaid 01936089
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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