Provider Demographics
NPI:1881972511
Name:NASSAU MEDICAL P.C.
Entity type:Organization
Organization Name:NASSAU MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-481-2232
Mailing Address - Street 1:961 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1646
Mailing Address - Country:US
Mailing Address - Phone:516-481-2232
Mailing Address - Fax:516-481-2368
Practice Address - Street 1:961 FRONT ST
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1646
Practice Address - Country:US
Practice Address - Phone:516-481-2232
Practice Address - Fax:516-481-2368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty