Organization Active NPI

Infectious Disease Medical Practice of Ny LLC

  • Infectious Disease Physician
  • Smithtown, NY
National Provider Identifier
1225255524
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INFECTIOUS DISEASE MEDICAL PRACTICE OF NY LLC
Practice address
48 Route 25a
Suite 308
Smithtown, NY 11787-1431
Phone
(631) 864-6111
Fax
(631) 864-5004
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Donna R. Lesser, DO
Title
President
Phone
(631) 864-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

48 Route 25a
Suite 308
Smithtown, NY 11787-1431

Mailing address

16 Medford LN
East Northport, NY 11731-5228
Phone (631) 864-6111

National Provider Directory

National Provider Directory

Locations

944 W Jericho Tpke
Ste 201
Smithtown, NY 11787
Phone (631) 864-6111

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1225255524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MEDFORD LN",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117315228",
            "telephone_number": "631-864-6111",
            "fax_number": "631-486-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 ROUTE 25A",
            "address_2": "SUITE 308",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871431",
            "telephone_number": "631-864-6111",
            "fax_number": "631-864-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE MEDICAL PRACTICE OF NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "LESSER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-864-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.