Active NPI
Nassau Spine Intraop Monitoring Medical
- Electroneurodiagnostic Specialist/Technologist
- Valley Stream, NY
National Provider Identifier
1659918316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- Legal business name
- NASSAU SPINE INTRAOP MONITORING MEDICAL
- Practice address
- 900 Franklin Ave
Valley Stream, NY 11580-2145 - Phone
- (516) 743-9450
- NPI assigned
- Dec 2, 2019
- Organization subpart
- Yes
- Parent organization
- NASSAU SPINE TEACHNICAL LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kanwarpaul Grewal, DO
- Title
- Owner
- Phone
- (516) 743-9450
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | Primary |
Addresses
Primary practice location
900 Franklin Ave
Valley Stream, NY 11580-2145
Mailing address
30 Merrick Ave Ste 103
East Meadow, NY 11554-1580
Phone (516) 743-9450
Other practice location 1
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 743-9450 ext. 3
Other practice location 2
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 743-9450 ext. 3
Other practice location 3
270 Park Ave
Huntington, NY 11743-2799
Phone (516) 743-9450 ext. 3
Other practice location 4
1000 N Village Ave
Rockville Centre, NY 11570-1000
Phone (516) 743-9405 ext. 3
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03918421 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | AdvanceMD | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Nassau Spine Intraop Monitoring Medical
- Part of
- Nassau Spine Intraop Monitoring Medical
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Electroneurodiagnostic Specialist/Technologist
- East Meadow, NY
- NPI 1235790015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575244800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576540800000",
"number": "1659918316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MERRICK AVE STE 103",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541580",
"telephone_number": "516-743-9450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 FRANKLIN AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115802145",
"telephone_number": "516-743-9450"
}
],
"practiceLocations": [
{
"address_1": "1000 Montauk Hwy",
"address_purpose": "LOCATION",
"city": "West Islip",
"state": "NY",
"postal_code": "117954927",
"country_code": "US",
"telephone_number": "516-743-9450 x3",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4295 Hempstead Tpke",
"address_purpose": "LOCATION",
"city": "Bethpage",
"state": "NY",
"postal_code": "117145713",
"country_code": "US",
"telephone_number": "516-743-9450 x3",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "270 Park Ave",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "NY",
"postal_code": "117432799",
"country_code": "US",
"telephone_number": "516-743-9450 x3",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 N Village Ave",
"address_purpose": "LOCATION",
"city": "Rockville Centre",
"state": "NY",
"postal_code": "115701000",
"country_code": "US",
"telephone_number": "516-743-9405 x3",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NASSAU SPINE INTRAOP MONITORING MEDICAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NASSAU SPINE TEACHNICAL LLC",
"enumeration_date": "2019-12-02",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A",
"authorized_official_last_name": "GREWAL",
"authorized_official_first_name": "KANWARPAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "516-743-9450",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03918421",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "AdvanceMD",
"affiliation": "N",
"endpointDescription": "AdvancedMD",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "AdvancedMD",
"address_1": "30 Merrick Ave Ste 103",
"city": "East Meadow",
"state": "NY",
"country_code": "US",
"postal_code": "115541580",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.