Active NPI
Nassau Nephrology LLP
- Nephrology Physician
- Bellmore, NY
National Provider Identifier
1639159775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- NASSAU NEPHROLOGY LLP
- Practice address
- 250 Pettit Avenue
Suite 4
Bellmore, NY 11710 - Phone
- (516) 409-0106
- Fax
- (516) 409-0108
- NPI assigned
- Jan 17, 2006
- Last updated
- Jun 20, 2018
- 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
- Ralph C Caselneva
- Title
- Nephrologist
- Phone
- (516) 409-0106
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | Primary |
Addresses
Primary practice location
250 Pettit Avenue
Suite 4
Bellmore, NY 11710
Mailing address
250 Pettit Avenue
Suite 4
Bellmore, NY 11710
Phone (516) 409-0106
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02044677 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529452800000",
"number": "1639159775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PETTIT AVENUE",
"address_2": "SUITE 4",
"city": "BELLMORE",
"state": "NY",
"postal_code": "11710",
"telephone_number": "516-409-0106",
"fax_number": "516-409-0108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PETTIT AVENUE",
"address_2": "SUITE 4",
"city": "BELLMORE",
"state": "NY",
"postal_code": "11710",
"telephone_number": "516-409-0106",
"fax_number": "516-409-0108"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NASSAU NEPHROLOGY LLP",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-17",
"last_updated": "2018-06-20",
"status": "A",
"authorized_official_last_name": "CASELNEVA",
"authorized_official_first_name": "RALPH",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "NEPHROLOGIST",
"authorized_official_telephone_number": "516-409-0106"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02044677",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.