Provider Demographics
NPI:1861660276
Name:MINIMALLY INVASSIVE SURGICAL ASSOCIATES OF LONG ISLAND
Entity Type:Organization
Organization Name:MINIMALLY INVASSIVE SURGICAL ASSOCIATES OF LONG ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SAHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-672-1641
Mailing Address - Street 1:3 ATKINSON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1102
Mailing Address - Country:US
Mailing Address - Phone:516-678-6263
Mailing Address - Fax:
Practice Address - Street 1:3 ATKINSON RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1102
Practice Address - Country:US
Practice Address - Phone:516-678-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty