Allergy & Pulmonary Medical of Long Island PC
Organization Active NPI Allergy Physician · Roslyn, NY
NPI 1003398595 · NPPES record last updated Aug 31, 2018
Key facts
- NPI
- 1003398595
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Allergy Physician 207KA0200X
- Legal business name
- ALLERGY & PULMONARY MEDICAL OF LONG ISLAND PC
- Practice address
- 9 Center Dr
Roslyn, NY 11576-1447 - Phone
- (347) 742-6336
- NPI assigned
- Aug 31, 2018
- Organization subpart
- No
Authorized official
- Name
- Pauline Fani, MD
- Title
- Physician
- Phone
- (347) 742-6336
Practitioners 1
-
Pauline Fani, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190703002558 | NY | Part B Supplier - Clinic/Group Practice | 4486989985 |
Receives reassigned benefits from 1 practitioner Practice locations: Great Neck, NY; Roslyn, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician |
207KA0200X | Yes |
Addresses
Primary practice location
9 Center Dr
Roslyn, NY 11576-1447
Mailing address
9 Center Dr
Roslyn, NY 11576-1447
Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.