Provider Demographics
NPI:1225059215
Name:EAST END PULMONARY CARE, P.C.
Entity Type:Organization
Organization Name:EAST END PULMONARY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:COLIN
Authorized Official - Last Name:MASSIAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-727-6717
Mailing Address - Street 1:1025 ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2735
Mailing Address - Country:US
Mailing Address - Phone:631-727-6717
Mailing Address - Fax:631-953-0204
Practice Address - Street 1:1025 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2735
Practice Address - Country:US
Practice Address - Phone:631-727-6717
Practice Address - Fax:631-953-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235602207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY223227POtherHIP ID #
NYP00260961OtherRAILROAD MEDICARE
NY1861894OtherCIGNA ID #
NY2144859OtherVYTRA ID #
NY299268OtherGHI ID #
NY235602OWOtherWORKER'S COMP ID #
NY8VO44OtherBCBS GROUP #
NYAA73450OtherMDNY ID #
NY2744154Medicaid
NY2744154Medicaid
NY235602OWOtherWORKER'S COMP ID #