Basic Information
| Provider Information | |||||||||
| NPI: | 1285976753 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NASSAU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2201 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115541859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165726511 | ||||||||
| FaxNumber: | 5165726120 | ||||||||
| Practice Location | |||||||||
| Address1: | 2201 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115541859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165726511 | ||||||||
| FaxNumber: | 5165726120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2013 | ||||||||
| LastUpdateDate: | 03/22/2013 | ||||||||
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| AuthorizedOfficialLastName: | SPERBER | ||||||||
| AuthorizedOfficialFirstName: | JACOB | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR PSYCHIATRY | ||||||||
| AuthorizedOfficialTelephone: | 5165725804 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.