Provider Demographics
NPI:1407096886
Name:SUN MEDICAL CARE OF NASSAU, P.C.
Entity Type:Organization
Organization Name:SUN MEDICAL CARE OF NASSAU, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SURYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:516-285-7605
Mailing Address - Street 1:1975 LINDEN BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4004
Mailing Address - Country:US
Mailing Address - Phone:516-285-7605
Mailing Address - Fax:516-285-7609
Practice Address - Street 1:1975 LINDEN BLVD STE 207
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4004
Practice Address - Country:US
Practice Address - Phone:516-285-7605
Practice Address - Fax:516-285-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204213261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service