Provider Demographics
NPI:1992195283
Name:NORTHEAST RHEUMATOLOGY PC
Entity Type:Organization
Organization Name:NORTHEAST RHEUMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAIFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-806-1434
Mailing Address - Street 1:7 PEBBLE LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2711
Mailing Address - Country:US
Mailing Address - Phone:718-886-4848
Mailing Address - Fax:718-886-5418
Practice Address - Street 1:85-49 ELIOT AVENUE UNIT G
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-424-2663
Practice Address - Fax:929-328-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270125207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty