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Organization

EAST END PAIN MANAGEMENT, LLC

Active
Other names
East End Pain Center
Organization subpart
No

Provider details

NPI number
Authorized official
JUAN J. GARGIULO M.D. (MEDICAL DIRECTOR)
(631) 702-2300
Entity
Organization

Contact information

Practice address
365 COUNTY ROAD 39A, SUITE 15 & 16, SOUTHAMPTON, NY 11968
(631) 702-2300
(631) 702-2303
Mailing address
365 COUNTY ROAD 39A, SUITE 15 & 16, SOUTHAMPTON, NY 11968
(631) 702-2300
(631) 702-2303

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
208VP0014X
Interventional Pain Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
361034200
FEDERAL WORKERS COMP
01
DA6752
RR MEDICARE
Enumeration date
05/26/2006
Last updated
02/16/2011
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