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Organization

EAST END PULMONARY CARE, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL COLIN MASSIAH M.D. (PHYSICIAN)
(631) 727-6717
Entity
Organization

Contact information

Practice address
1025 ROANOKE AVE, RIVERHEAD, NY 11901-2735
(631) 727-6717
(631) 953-0204
Mailing address
1025 ROANOKE AVE, RIVERHEAD, NY 11901-2735
(631) 727-6717
(631) 953-0204

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
235602
NY
207RP1001X
Pulmonary Disease Physician
Primary
235602
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1861894
CIGNA ID #
NY
01
2144859
VYTRA ID #
NY
01
223227P
HIP ID #
NY
01
235602OW
WORKER'S COMP ID #
NY
05
2744154
NY
01
299268
GHI ID #
NY
01
8VO44
BCBS GROUP #
NY
01
AA73450
MDNY ID #
NY
01
P00260961
RAILROAD MEDICARE
NY
Enumeration date
07/22/2006
Last updated
10/05/2012
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