Provider Demographics
NPI:1083931612
Name:PULMONARY CRITICAL CARE & SLEEP MEDICINE OF NASSAU P.C.
Entity Type:Organization
Organization Name:PULMONARY CRITICAL CARE & SLEEP MEDICINE OF NASSAU P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRISHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-347-0411
Mailing Address - Street 1:65-11 BOOTH STREET
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4184
Mailing Address - Country:US
Mailing Address - Phone:718-806-1434
Mailing Address - Fax:718-806-1435
Practice Address - Street 1:250-12 HILLSIDE AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2139
Practice Address - Country:US
Practice Address - Phone:718-347-0411
Practice Address - Fax:718-347-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241650207R00000X, 207RP1001X, 207RS0012X, 207RS0012X, 207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty