Provider Demographics
NPI:1669627634
Name:LONG ISLAND HAND & ORTHOPEDIC SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:LONG ISLAND HAND & ORTHOPEDIC SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-427-4263
Mailing Address - Street 1:166 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2948
Mailing Address - Country:US
Mailing Address - Phone:631-812-2663
Mailing Address - Fax:631-683-5907
Practice Address - Street 1:166 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2948
Practice Address - Country:US
Practice Address - Phone:631-427-4263
Practice Address - Fax:631-427-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical