Organization Name: | EASTERN LONG ISLAND GENERAL AND VASCULAR SURGERY PC |
NPI Number: | 1083839617 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD J RICCA (SURGEON) |
Mailing Address: | 335a Meeting House Ln Southampton |
State: | NY US |
Postal Code: | 119685051 |
Phone Number: | 6312876570 |
Fax Number: | 6312876578 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 04/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 143299 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |