Active NPI
DRS Blau, Tiger, Sullivan, Sumner
- Rheumatology Physician
- Massapequa, NY
National Provider Identifier
1417012790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 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 DirectoryLocations
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.
-
- Rheumatology Physician
- Massapequa, NY
- NPI 1902960891
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.