Organization
EAST END GERIATRIC & ADULT MEDICINE PLLC
Active
Other names
Professional Limited Liability Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY P SLOTKIN MD (PRESIDENT)
(631) 765-1414
Entity
Organization
Contact information
Practice address
50 ACKERLY POND LANE, SOUTHOLD, NY 11971-3005
(631) 765-1414
(631) 765-1428
Mailing address
PO BOX 1437, SOUTHOLD, NY 11971-0938
(631) 765-1414
(631) 765-1428
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
23013867
NY
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02632497
—
NY
01
—
DD8034
RAIL ROAD MEDICARE
NY
Enumeration date
02/24/2006
Last updated
07/03/2012
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