SOUTH NASSAU PHYSICIAN PRACTICE PC (NPI# 1962652685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962652685 |
| Entity Type | Organization |
| Organization Name | SOUTH NASSAU PHYSICIAN PRACTICE PC |
| Practice Address |
1 S Central Ave Valley Stream NY 11580-5443 |
| Practice Telephone | 5166323350 |
| Practice Fax Number | 5166323355 |
| Mailing Telephone | 5166323350 |
| Mailing Fax Number | 5166323355 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |
| Authorized Official Name | RAJIV V DATTA (DIRECTOR) |
| Authorized Official Telephone | 5166323350 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 200879 | NY | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 242239 | NY | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 201327 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1 S CENTRAL AVE |
| City | VALLEY STREAM |
| State | NY |
| Zip Code | 11580-5443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457347601 | Rajiv Datta | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2005-09-23 |
| 1104200641 | South Nassau Physicians PC | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2015-07-15 |
| 1083055958 | Hideo Takahashi | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2013-07-08 |
| 1043570286 | South Nassau Obstetrics & Gynecology, PC | Obstetrics & Gynecology | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2012-05-22 |
| 1427360304 | Kathleen Anne Lehmann | Nurse Practitioner | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2010-07-08 |
| 1285899583 | Long Island Medical Oncology & Hematology Assoc. P.C. | Specialist | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2008-07-25 |
| 1932375755 | Abbe Nadel | Nurse Practitioner | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2008-05-01 |
| 1285765156 | Nancy T Rosenthal | Nurse Practitioner | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2007-03-09 |
| 1518982610 | Olga Liberman | Specialist | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807276 | Jason Diana Lmsw | Clinic/Center | 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 | 2020-10-09 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1427523869 | Jessica Doyle | Social Worker | 5-11 Pflug Pl, Valley Stream, NY 11580 | 2018-10-12 |
| 1013491026 | Syeda Afshan Firdous | Licensed Practical Nurse | 13 Cleaveland St, Valley Stream, NY 11580 | 2018-09-17 |
| 1700377934 | Jisha Merin Mathew | Nurse Practitioner | 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 | 2018-05-23 |
| 1669970273 | Terrice Bell | Social Worker | 50 W Hawthorne Avenue, Valley Streams, NY 11580 | 2018-01-29 |
| 1659883718 | Rita M. Fowler | Registered Nurse | 33 West Hawthorne Ave. Suite 31, New York Health Care, Valley Stream, NY 11580 | 2017-10-30 |
| 1881104768 | Sharon Stephenson | Peer Specialist | 51 Foster Avenue, North Valley Stream, Valley Stream, NY 11580 | 2017-10-05 |
| 1356850200 | Barry Henderson | Case Manager/Care Coordinator | 23 Marlow Road, Valley Stream, NY 11580 | 2017-09-22 |
| 1922526565 | Aneta Kaczmarski | Physical Therapy Assistant | 299 North Corona Ave, Valley Stream, NY 11580 | 2017-09-05 |
| Find all providers in zip 11580 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720209521 | Noel Edwin Blackman | Surgery | 83 Law St, Valley Stream, NY 11580 | 2007-05-01 |
| 1982646410 | Fred Nicolas | Surgery | 766 Daniel St, Valley Stream, NY 11581-3502 | 2006-06-11 |
| 1174564264 | Ira Klonsky | Surgery | 210 E Sunrise Hwy, Suite 303, Valley Stream, NY 11581-1329 | 2006-06-09 |
| 1205442100 | Madeleine Ann Reyes | Surgery | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-09-17 |
| 1104200641 | South Nassau Physicians PC | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2015-07-15 |
| 1245575448 | Li Premier Medical Care Pllc | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2012-11-29 |
| 1972656437 | Island Surgical Practice PC | Surgery | 210 E Sunrise Hwy, Suite 303, Valley Stream, NY 11581-1329 | 2007-01-19 |
| 1679635833 | Rafael C Hernandez | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2006-12-14 |
| 1588726715 | Victor Hugo Taranto | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2006-12-14 |
| 1497797666 | John Lundie | Surgery | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2006-06-12 |
| Find all providers in VALLEY STREAM | ||||
| City | VALLEY STREAM |
| Zip Code | 11580 |
Please comment or provide details below to improve the information on SOUTH NASSAU PHYSICIAN PRACTICE PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.