Organization
SOUTH BROOKHAVEN OBSTETRIC & GYNECOLOGIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAPHNA KILION M.D. (PRESIDENT)
(631) 475-5250
Entity
Organization
Contact information
Practice address
444 W MAIN ST, PATCHOGUE, NY 11772-3012
(631) 475-5250
(631) 475-9536
Mailing address
444 W MAIN ST, PATCHOGUE, NY 11772-3012
(631) 475-5250
(631) 475-9536
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100001644
RAILROAD MEDICARE
NY
Enumeration date
02/26/2009
Last updated
02/27/2012
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