NPIMap

Organization Active NPI

Prohealth Care Associates, LLP

  • Clinical Medical Laboratory
  • Bethpage, NY
National Provider Identifier
1700960440
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
33D0156362 Issued in NY
Legal business name
PROHEALTH CARE ASSOCIATES, LLP
Practice address
4045 Hempstead Tpke
Bethpage, NY 11714-5611
Phone
(516) 731-7770
Fax
(516) 731-7059
NPI assigned
Oct 25, 2006
Organization subpart
Yes
Parent organization
PROHEALTH CARE ASSOCIATES, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. David Cooper, M.D.
Title
Ceo, Managing Partner
Phone
(516) 622-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 33D0156362 NY Primary

Addresses

Primary practice location

4045 Hempstead Tpke
Bethpage, NY 11714-5611

Mailing address

1 Dakota Drive
Suite 320
Lake Success, NY 11042
Phone (516) 622-6190

Other identifiers 1

IdentifierTypeStateIssuer
A300055237OtherNYMEDICARE ID

Other names 2

  • Bethpage Medical Laboratory A Division of ProHealth Care Associates, LLP Doing business as
  • Island Medical Group A Division of ProHealth Care Associates, LLP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prohealth Care Associates6 organizations share this tax ID, including this one
Part of
Prohealth Care Associates

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4277 Hempstead Tpke
Ste 209
Bethpage, NY 11714
Phone (516) 731-7770

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1700960440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DAKOTA DRIVE",
            "address_2": "SUITE 320",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-622-6190",
            "fax_number": "516-622-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 HEMPSTEAD TPKE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145611",
            "telephone_number": "516-731-7770",
            "fax_number": "516-731-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH CARE ASSOCIATES, LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH CARE ASSOCIATES, LLP",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO, MANAGING PARTNER",
        "authorized_official_telephone_number": "516-622-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "33D0156362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "A300055237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethpage Medical Laboratory A Division of ProHealth Care Associates, LLP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Island Medical Group A Division of ProHealth Care Associates, LLP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.