Provider Demographics
NPI:1710141445
Name:RHEUMATOLOGY ASSOCIATES OF NEW YORK PLLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES OF NEW YORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARI
Authorized Official - Middle Name:D
Authorized Official - Last Name:EDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-775-7200
Mailing Address - Street 1:866 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4531
Mailing Address - Country:US
Mailing Address - Phone:516-775-7200
Mailing Address - Fax:516-565-4546
Practice Address - Street 1:1991 MARCUS AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-775-7200
Practice Address - Fax:516-565-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241129207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherBUSINESS EIN