Organization
SOUTH FORK MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL B ISRAEL MD (PRACTICES MANAGING MEMBER)
(631) 283-2100
Entity
Organization
Contact information
Practice address
238 OLD TOWN ROAD, SOUTHAMPTON, NY 11968
(631) 283-2100
(631) 283-5731
Mailing address
PO BOX 2340, SOUTHAMPTON, NY 11969-2340
(631) 283-2100
(631) 283-5731
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/02/2006
Last updated
09/11/2025
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