Provider Demographics
NPI:1295924728
Name:ADVANCED RHEUMATOLOGY, P.C.
Entity type:Organization
Organization Name:ADVANCED RHEUMATOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMINFARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-424-9090
Mailing Address - Street 1:120 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2816
Mailing Address - Country:US
Mailing Address - Phone:631-424-9090
Mailing Address - Fax:631-424-9091
Practice Address - Street 1:120 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2816
Practice Address - Country:US
Practice Address - Phone:631-424-9090
Practice Address - Fax:631-424-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206519174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ261Medicare PIN
NY80V791Medicare UPIN