Provider Demographics
NPI:1376810424
Name:DEMETERIO & NEJATHEIM MD PC
Entity Type:Organization
Organization Name:DEMETERIO & NEJATHEIM MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEJATHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-825-1667
Mailing Address - Street 1:265 E MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6004
Mailing Address - Country:US
Mailing Address - Phone:516-825-1667
Mailing Address - Fax:516-825-4006
Practice Address - Street 1:265 E MERRICK RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6004
Practice Address - Country:US
Practice Address - Phone:516-825-1667
Practice Address - Fax:516-825-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty