Provider Demographics
NPI:1013059930
Name:LIONEL BARRAU M.D. & MARC J. YUNIS M.D.
Entity Type:Organization
Organization Name:LIONEL BARRAU M.D. & MARC J. YUNIS M.D.
Other - Org Name:KIDNEY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER MEDICAL PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-488-0150
Mailing Address - Street 1:30 DEER PATH ROAD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1602
Mailing Address - Country:US
Mailing Address - Phone:516-488-0150
Mailing Address - Fax:516-326-6252
Practice Address - Street 1:22202 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429
Practice Address - Country:US
Practice Address - Phone:718-217-6200
Practice Address - Fax:718-217-4191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114445207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00209518Medicaid
NY00209518Medicaid
NYW34821Medicare PIN
NY03837Medicare PIN