Provider Demographics
NPI:1093844243
Name:ISLAND PULMONARY ASSOCIATION PC
Entity Type:Organization
Organization Name:ISLAND PULMONARY ASSOCIATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RABINOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-796-3700
Mailing Address - Street 1:4271 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5708
Mailing Address - Country:US
Mailing Address - Phone:516-796-3700
Mailing Address - Fax:516-796-3205
Practice Address - Street 1:4271 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 1
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5708
Practice Address - Country:US
Practice Address - Phone:516-796-3700
Practice Address - Fax:516-796-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW0815100Medicare ID - Type Unspecified