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Organization

SOUTH FORK GYNECOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LOUISE M COLLINS MD (PRESIDENT PHYSICIAN)
(631) 329-6500
Entity
Organization

Contact information

Practice address
200 PANTIGO PLACE, SUITE D, EAST HAMPTON, NY 11937
(631) 329-6500
(631) 329-7832
Mailing address
200 PANTIGO PLACE, SUITE D, EAST HAMPTON, NY 11937
(631) 329-6500
(631) 329-7832

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
221321
NY

Other

Enumeration date
01/15/2008
Last updated
01/15/2008
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