Eastern Suffolk Nephrology PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

143580 Issued in NY

Legal business name

EASTERN SUFFOLK NEPHROLOGY PC

Practice address

758 Harrison Ave
Riverhead, NY 11901-2744

Phone

(631) 727-5112

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Purshotam Lal Nagwani, M.D.

Title

Owner

Phone

(631) 727-5112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1831243880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 HARRISON AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012744",
            "telephone_number": "631-727-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 HARRISON AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012744",
            "telephone_number": "631-727-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SUFFOLK NEPHROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "NAGWANI",
        "authorized_official_first_name": "PURSHOTAM",
        "authorized_official_middle_name": "LAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-727-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "143580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.