Organization Active NPI

Long Island Health & Wellness Family Medicine, P.C.

  • Family Medicine Physician
  • Amityville, NY
National Provider Identifier
1487731279
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209721 Issued in NY
Legal business name
LONG ISLAND HEALTH & WELLNESS FAMILY MEDICINE, P.C.
Practice address
197 Broadway
Amityville, NY 11701
Phone
(631) 691-1500
Fax
(631) 691-1503
NPI assigned
Nov 1, 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. Donato Michael Balsamo, D.O.
Title
President
Phone
(631) 691-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 209721 NY Primary

Addresses

Primary practice location

197 Broadway
Amityville, NY 11701

Mailing address

282A Higbie Lane
#279
West Islip, NY 11795
Phone (631) 691-1500

National Provider Directory

National Provider Directory

Locations

197 Broadway
Amityville, NY 11701
Phone (631) 691-1500

282 Higbie Ln
Unit A
West Islip, NY 11795

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487731279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282A HIGBIE LANE",
            "address_2": "#279",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "11795",
            "telephone_number": "631-691-1500",
            "fax_number": "631-691-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-691-1500",
            "fax_number": "631-691-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND HEALTH & WELLNESS FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALSAMO",
        "authorized_official_first_name": "DONATO",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-691-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, 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.