Provider Demographics
NPI:1326201195
Name:ENDRES, PAUL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JAMES
Last Name:ENDRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1215
Mailing Address - Street 2:
Mailing Address - City:QUOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11959-1215
Mailing Address - Country:US
Mailing Address - Phone:212-729-7228
Mailing Address - Fax:
Practice Address - Street 1:82 JESSUP AVENUE
Practice Address - Street 2:PO BOX 1215
Practice Address - City:QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11959-1215
Practice Address - Country:US
Practice Address - Phone:212-729-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224631207Q00000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine