Nanticoke Medical Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NANTICOKE MEDICAL CENTER LLC

Practice address

128 W Washington St
Nanticoke, PA 18634-3113

Phone

(718) 534-7888

Fax

(718) 874-0088

NPI assigned

Mar 10, 2020

Organization subpart

No

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

Authorized official

Name

Shahid Rasul, MD

Title

Ceo

Phone

(917) 774-1787

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1780219840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3945",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110408945",
            "telephone_number": "917-774-1787",
            "fax_number": "718-874-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W WASHINGTON ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343113",
            "telephone_number": "718-534-7888",
            "fax_number": "718-874-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTICOKE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "RASUL",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-774-1787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thomas Nawrocki, PA-C
• Tracey Neary, D.D.S.
• Newport Township Firemen's Community
• Newport Township Firemens Community Ambulance

• Clinic/Center in Nanticoke, PA
• Providers in Nanticoke, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.