Provider Demographics
NPI:1477575926
Name:EAST END HOSPICE, INC
Entity type:Organization
Organization Name:EAST END HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MPH, CHPN
Authorized Official - Phone:631-288-8400
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-7048
Mailing Address - Country:US
Mailing Address - Phone:631-288-8400
Mailing Address - Fax:631-288-8492
Practice Address - Street 1:481 WESTHAMPTON-RIVERHEAD RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-7048
Practice Address - Country:US
Practice Address - Phone:631-288-8400
Practice Address - Fax:631-288-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5158500F251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01268437Medicaid
NY01268437Medicaid