Organization
EAST END GASTROENTEROLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J CORONEL MD (PHYSICIAN / OWNER)
(631) 591-3000
Entity
Organization
Contact information
Practice address
287 WADING RIVER RD, UNIT 2, MANORVILLE, NY 11949-3383
(631) 591-3000
(631) 591-1734
Mailing address
856 BRYANT ST, WOODMERE, NY 11598-2540
(631) 591-3000
(631) 591-1734
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
207ZC0006X
Clinical Pathology Physician
—
—
Other
Enumeration date
03/16/2021
Last updated
12/30/2022
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