Basic Information
| Provider Information | |||||||||
| NPI: | 1093844243 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ISLAND PULMONARY ASSOCIATION PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4271 HEMPSTEAD TPKE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | BETHPAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117145708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167963700 | ||||||||
| FaxNumber: | 5167963205 | ||||||||
| Practice Location | |||||||||
| Address1: | 4271 HEMPSTEAD TPKE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | BETHPAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117145708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167963700 | ||||||||
| FaxNumber: | 5167963205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 09/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | RABINOWITZ | ||||||||
| AuthorizedOfficialFirstName: | STANLEY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CO-PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5167963700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.