Provider Demographics
NPI:1922285105
Name:GREAT NECK HEMATOLOGY&ONCOLOGY.P.C.
Entity Type:Organization
Organization Name:GREAT NECK HEMATOLOGY&ONCOLOGY.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-482-0080
Mailing Address - Street 1:107 NORTHERN BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4309
Mailing Address - Country:US
Mailing Address - Phone:516-482-0080
Mailing Address - Fax:516-482-8653
Practice Address - Street 1:107 NORTHERN BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4309
Practice Address - Country:US
Practice Address - Phone:516-482-0080
Practice Address - Fax:516-482-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140227207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ351Medicare PIN
NYCO9260Medicare UPIN