Provider Demographics
NPI:1447448683
Name:EAST SHORE SURGERY P.C.
Entity type:Organization
Organization Name:EAST SHORE SURGERY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSARIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-858-2152
Mailing Address - Street 1:315 E SHORE RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2923
Mailing Address - Country:US
Mailing Address - Phone:516-858-2152
Mailing Address - Fax:
Practice Address - Street 1:315 E SHORE RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2923
Practice Address - Country:US
Practice Address - Phone:516-858-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty