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NPI Code Detail

MEDICARE: COLON & RECTAL ASSOCIATES OF NASSAU, PLLC

MEDICARE: COLON & RECTAL ASSOCIATES OF NASSAU, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208C00000XColon & Rectal Surgery Physician

General Provider Information

NPI Number : 1669609632
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLON & RECTAL ASSOCIATES OF NASSAU, PLLC
Provider Business Mailing Address
First Line : 1100 FRANKLIN AVE
Second Line : SUITE 203
City : GARDEN CITY
State : NY
Zip : 11530-3221
Country : US
Telephone Number : 516-248-2422
Fax Number : 516-248-5162
Provider Business Practice Location Address
First Line : 1100 FRANKLIN AVE
Second Line : SUITE 203
City : GARDEN CITY
State : NY
Zip : 11530-3221
Country : US
Telephone Number : 516-248-2422
Fax Number : 516-248-5162
Authorized Official
Title or Position : OWNER
Name : DR. DEAN P. PAPPAS
Credential : M.D.
Telephone Number : 516-248-2422
Provider Enumeration Date : 06/17/2009
Last Update Date : 10/08/2015

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