Provider Demographics
NPI:1609002146
Name:EASTERN LONG ISLAND HOSPITAL ASSOC INC
Entity Type:Organization
Organization Name:EASTERN LONG ISLAND HOSPITAL ASSOC INC
Other - Org Name:CRNA SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-477-5711
Mailing Address - Street 1:201 MANOR PL
Mailing Address - Street 2:CRNA SERVICES
Mailing Address - City:GREENPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11944-1222
Mailing Address - Country:US
Mailing Address - Phone:631-477-1000
Mailing Address - Fax:631-477-5369
Practice Address - Street 1:201 MANOR PL
Practice Address - Street 2:
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1222
Practice Address - Country:US
Practice Address - Phone:631-477-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTERN LONG ISLAND HOSPITAL ASSOC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-10
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty