Organization Active NPI

Long Island Diabetes & Endocrinology, PC

  • Medical Specialty Clinic/Center
  • Babylon, NY
National Provider Identifier
1770727935
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
2075821 Issued in NY
Legal business name
LONG ISLAND DIABETES & ENDOCRINOLOGY, PC
Practice address
421 Deer Park Ave
Babylon, NY 11702-2313
Phone
(631) 941-1000
Fax
(631) 941-1010
NPI assigned
Apr 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Mr. Barbara H O'Brien
Title
Office Administrator
Phone
(631) 941-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 2075821 NY Primary

Addresses

Primary practice location

421 Deer Park Ave
Babylon, NY 11702-2313

Mailing address

415 Garden St
Bellmore, NY 11710-4517
Phone (631) 941-1000

Other identifiers 2

IdentifierTypeStateIssuer
1962496968OtherNYNPI-GROUP
1497740781OtherNYNPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1770727935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 GARDEN ST",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117104517",
            "telephone_number": "631-941-1000",
            "fax_number": "631-941-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022313",
            "telephone_number": "631-941-1000",
            "fax_number": "631-941-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND DIABETES & ENDOCRINOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "631-941-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "2075821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-GROUP",
            "identifier": "1962496968",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497740781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.