Provider Demographics
NPI:1710008644
Name:LONG ISLAND PULMONARY AND SLEEP MEDICINE ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:LONG ISLAND PULMONARY AND SLEEP MEDICINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:SAVERIO
Authorized Official - Last Name:COLETTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-536-8151
Mailing Address - Street 1:200 N VILLAGE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2341
Mailing Address - Country:US
Mailing Address - Phone:516-536-8151
Mailing Address - Fax:516-536-8153
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:516-536-8151
Practice Address - Fax:516-536-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187532207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWBW611OtherMEDICARE PTAN