Organization
EASTERN LONG ISLAND SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEDHAT E ALLAM MD (SOLE OWNER)
(631) 287-6202
Entity
Organization
Contact information
Practice address
365 COUNTY RD 39A, SUITE 11, SOUTHAMPTON, NY 11968
(631) 287-6202
(631) 287-6213
Mailing address
365 COUNTY RD 39A, SUITE 11, SOUTHAMPTON, NY 11968
(631) 287-6202
(631) 287-6213
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
193888
NY
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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