Provider Demographics
NPI:1376772533
Name:LONG ISLAND PULMONARY ASSOCIATES, PC
Entity Type:Organization
Organization Name:LONG ISLAND PULMONARY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-766-6766
Mailing Address - Street 1:2000 N VILLAGE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1078
Mailing Address - Country:US
Mailing Address - Phone:516-766-6766
Mailing Address - Fax:516-678-0065
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-766-6766
Practice Address - Fax:516-678-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RP1001X
NY124431207RP1001X
NY128745207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100028363Medicare PIN