Provider Demographics
NPI:1245420249
Name:LONG ISLAND MEDICAL CARE SERVICES PC
Entity Type:Organization
Organization Name:LONG ISLAND MEDICAL CARE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-587-6060
Mailing Address - Street 1:986 SUNRISE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-0000
Mailing Address - Country:US
Mailing Address - Phone:631-587-6060
Mailing Address - Fax:631-587-1364
Practice Address - Street 1:986 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6111
Practice Address - Country:US
Practice Address - Phone:631-587-6060
Practice Address - Fax:631-587-1364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW9L221Medicare PIN
NYCL3873Medicare PIN