Provider Demographics
NPI:1801938105
Name:NASSAU SURGICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:NASSAU SURGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KHALIFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-741-4138
Mailing Address - Street 1:300 OLD COUNTRY AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-741-4138
Mailing Address - Fax:516-294-4301
Practice Address - Street 1:300 OLD COUNTRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4198
Practice Address - Country:US
Practice Address - Phone:516-741-4138
Practice Address - Fax:516-294-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty