Organization Active NPI

DRS Blau, Tiger, Sullivan, Sumner

  • Rheumatology Physician
  • Massapequa, NY
National Provider Identifier
1417012790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
DRS BLAU, TIGER, SULLIVAN, SUMNER
Practice address
566 Broadway
Massapequa, NY 11758-5017
Phone
(516) 544-6262
Fax
(516) 541-0011
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sheldon Blau
Title
Owner
Phone
(516) 541-6262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

566 Broadway
Massapequa, NY 11758-5017

Mailing address

566 Broadway
Massapequa, NY 11758-5017
Phone (516) 544-6262

National Provider Directory

National Provider Directory

Locations

566 Broadway
North Massapequa, NY 11758
Phone (516) 799-6616

Practitioners & affiliated clinicians

Practitioners 1

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417012790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585017",
            "telephone_number": "516-544-6262",
            "fax_number": "516-541-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585017",
            "telephone_number": "516-544-6262",
            "fax_number": "516-541-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS BLAU, TIGER, SULLIVAN, SUMNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-541-6262",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.