EASTERN SUFFOLK SPINE AND PAIN MEDICINE, PLLC

SOUTHOLD, NY
NPI1568223923
Entity TypeOrganization
Authorized ContactNITIN MARIWALLA
CEO
631-885-2406
Organization Subpart ?No
Primary Taxonomy207RG0100X Internal Medicine, Gastroenterology
Additional Taxonomies207L00000X Anesthesiology
207T00000X Neurological Surgery
Enumeration Date2024-01-22
Last Update Date2025-07-30
Business Address
EASTERN SUFFOLK SPINE AND PAIN MEDICINE, PLLC
700 BOISSEAU AVE
SOUTHOLD, NY 11971-2926
Phone number: 631-477-5353
Mailing Address
EASTERN SUFFOLK SPINE AND PAIN MEDICINE, PLLC
3 FRANCES LN
PORT JEFFERSON, NY 11777-1125
Phone number: 570-814-4146