East End Physician Services PC

NPI #1407191364 in Southold, New York

Provider Information

NPI Number: 1407191364
Entity Type: Organization
Organization Name: East End Physician Services PC
Primary Specialty: Internal Medicine
Enumeration Date: Dec 4, 2012
Last Updated: Jun 14, 2017

Practice Location

Address: 44210 COUNTY RD. 48
City: Southold
State: New York
ZIP Code: 11971
Phone: (631) 765-4150

Authorized Official

Name: DR. LLOYD DOUGLAS SIMON, MD
Title: PRESIDENT (CORPORATION)
Phone: (631) 765-4150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Addiction Medicine — Addiction Medicine	207RA0401X
Internal Medicine	207R00000X	Primary

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