East End Pain Management, LLC
Anesthesiology, Pain Medicine in Southampton, NY. Organization (NPI-2).
NPI number1902852247
StatusActive
Last updated in NPPESFeb 16, 2011
Details
- NPI
- 1902852247
- Entity type
- Organization (NPI-2)
- Legal business name
- East End Pain Management, LLC
- Organization subpart
- No
- Enumeration date
- May 26, 2006
- Last updated
- Feb 16, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | – | – | Yes |
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – |
Other names
- East End Pain Center (Doing Business As)
Practice location
365 County Road 39aSuite 15 & 16
Southampton, NY 11968
Phone 631-702-2300 · Fax 631-702-2303
Mailing address
365 County Road 39aSuite 15 & 16
Southampton, NY 11968
Phone 631-702-2300 · Fax 631-702-2303
Authorized official
Juan J. Gargiulo
Medical Director
6317022300
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