Provider Demographics
NPI:1588016729
Name:LONG ISLAND OBESITY SURGERY, PC
Entity Type:Organization
Organization Name:LONG ISLAND OBESITY SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-351-2024
Mailing Address - Street 1:224 WALL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2186
Mailing Address - Country:US
Mailing Address - Phone:631-351-2024
Mailing Address - Fax:631-271-0970
Practice Address - Street 1:224 WALL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2186
Practice Address - Country:US
Practice Address - Phone:631-351-2024
Practice Address - Fax:631-271-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227221208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty