Walt Whitman Aa, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

WALT WHITMAN AA, LLC

Practice address

1895 Walt Whitman Rd
Ste 10
Melville, NY 11747-3031

Phone

(631) 293-9700

Fax

(631) 293-2021

NPI assigned

Jun 27, 2013

Last updated

Jun 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay S Youngerman, MD

Title

President

Phone

(631) 293-9700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1588004154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 WALT WHITMAN RD",
            "address_2": "PO BOX 1109",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117476600",
            "telephone_number": "631-293-9700",
            "fax_number": "631-293-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 WALT WHITMAN RD",
            "address_2": "STE 10",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473031",
            "telephone_number": "631-293-9700",
            "fax_number": "631-293-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALT WHITMAN AA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "YOUNGERMAN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-293-9700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawanda Walker
• Algernon Anthony Stephen Waller
• Nichole Walling
• Amanda Rizzo Walsh, MD, MS
• Tara Walsh, OTR/L
• Alyssa Walter
• Samantha Walter
• Laine Walterson
• Lauren Wandy, LCSW
• Cassidy Elyse Ward

• Anesthesiology Physician in Melville, NY
• Providers in Melville, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.