Provider Demographics
NPI:1689692162
Name:LONG ISLAND INTERNAL MEDICINE ASSOCIATES P.C.
Entity Type:Organization
Organization Name:LONG ISLAND INTERNAL MEDICINE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-536-0600
Mailing Address - Street 1:2 LINCOLN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5775
Mailing Address - Country:US
Mailing Address - Phone:516-536-0600
Mailing Address - Fax:516-536-0694
Practice Address - Street 1:2 LINCOLN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5775
Practice Address - Country:US
Practice Address - Phone:516-536-0600
Practice Address - Fax:516-536-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty