Provider Demographics
NPI:1396013777
Name:PROHEALTH CARE ASSOCIATES LLP
Entity Type:Organization
Organization Name:PROHEALTH CARE ASSOCIATES LLP
Other - Org Name:NASSAU ORTHOPEDIC SURGEONS DME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-622-6000
Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6196
Mailing Address - Fax:
Practice Address - Street 1:2920 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 7
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1402
Practice Address - Country:US
Practice Address - Phone:516-735-4048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROHEALTH CARE ASSOCIATES LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-13
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6634650001OtherMEDICARE PTAN