Wantagh Internal Medicine, PC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

1398351 Issued in NY

Legal business name

WANTAGH INTERNAL MEDICINE, PC

Practice address

2155 Wantagh Ave
Wantagh, NY 11793-3915

Phone

(516) 785-1200

Fax

(516) 785-8969

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Eric R Barth, M.D

Title

Doctor

Phone

(516) 785-1200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1629256342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933915",
            "telephone_number": "516-785-1200",
            "fax_number": "516-785-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933915",
            "telephone_number": "516-785-1200",
            "fax_number": "516-785-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANTAGH INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "BARTH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "516-785-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "1398351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Community Health Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.