Pediatric Pulmonary Medicine PC

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

Legal business name

PEDIATRIC PULMONARY MEDICINE PC

Practice address

90 Fulton Blvd
Commack, NY 11725-1711

Phone

(516) 680-0924

NPI assigned

Aug 31, 2015

Last updated

Aug 31, 2015By 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

Dmitriy Vaysman, MD

Title

President

Phone

(516) 680-0924

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1740657360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SAINT NICHOLAS AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852296",
            "telephone_number": "718-456-9679",
            "fax_number": "718-418-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FULTON BLVD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251711",
            "telephone_number": "516-680-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PULMONARY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "VAYSMAN",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-680-0924",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Pulmonology Physician in Commack, NY
• Providers in Commack, NY by specialty
• Pediatric Pulmonology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.