Healthcare Provider Details

I. General information

NPI: 1760407571
Provider Name (Legal Business Name): EAST END PEDIATRICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PANTIGO PL SUITE E
EAST HAMPTON NY
11937-5920
US

IV. Provider business mailing address

200 PANTIGO PL SUITE E
EAST HAMPTON NY
11937-5920
US

V. Phone/Fax

Practice location:
  • Phone: 631-324-8030
  • Fax: 631-324-8032
Mailing address:
  • Phone: 631-324-8030
  • Fax: 631-324-8032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GAIL SCHONFELD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 631-324-8030