| Organization Name: | SOUTH FORK GYNECOLOGY |
| NPI Number: | 1295911741 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOUISE M COLLINS (PRESIDENT PHYSICIAN) |
| Mailing Address: | 200 Pantigo Place Suite D East Hampton |
| State: | NY US |
| Postal Code: | 11937 |
| Phone Number: | 6313296500 |
| Fax Number: | 6313297832 |
| NPI Enumeration Date: | 01/15/2008 |
| NPI Last Update Date: | 01/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 221321 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |