Organization Active NPI

South Nassau Cardiovascular Practice, PC

  • Cardiovascular Disease Physician
  • Hewlett, NY
National Provider Identifier
1447545843
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
180648 Issued in NY
Legal business name
SOUTH NASSAU CARDIOVASCULAR PRACTICE, PC
Practice address
1200 W Broadway
Hewlett, NY 11557-1913
Phone
(516) 887-7000
NPI assigned
Jun 14, 2011
Organization subpart
Yes
Parent organization
SOUTH NASSAU COMMUNITIES HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Authorized official

Name
Mark Bogen
Title
VP Finance
Phone
(516) 632-3965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 180648 NY Primary

Addresses

Primary practice location

1200 W Broadway
Hewlett, NY 11557-1913

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3965

National Provider Directory

National Provider Directory
Part of
So Nassau Comm Hosp

Practitioners & affiliated clinicians

Practitioners 2

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": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1447545843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571913",
            "telephone_number": "516-887-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH NASSAU CARDIOVASCULAR PRACTICE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH NASSAU COMMUNITIES HOSPITAL",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "BOGEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "516-632-3965"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "180648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.