Provider Demographics
NPI:1467545202
Name:LONG ISLAND NEPHROLOGY CONSULTANTS
Entity Type:Organization
Organization Name:LONG ISLAND NEPHROLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-331-4403
Mailing Address - Street 1:701 ROUTE 25A
Mailing Address - Street 2:SUITE B1
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2050
Mailing Address - Country:US
Mailing Address - Phone:631-331-4403
Mailing Address - Fax:631-331-1932
Practice Address - Street 1:701 ROUTE 25A
Practice Address - Street 2:SUITE B1
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2050
Practice Address - Country:US
Practice Address - Phone:631-331-4403
Practice Address - Fax:631-331-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01552161OtherMEDICAID GROUP
NYCN3387OtherRAILROAD MEDICARE GROUP
NY01552161OtherMEDICAID GROUP