Healthcare Provider Details

I. General information

NPI: 1851899900
Provider Name (Legal Business Name): THE NEW PROTOCOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 CARNATION DR
FARMINGDALE NY
11735-7009
US

IV. Provider business mailing address

204 CARNATION DR
FARMINGDALE NY
11735-7009
US

V. Phone/Fax

Practice location:
  • Phone: 516-321-0312
  • Fax:
Mailing address:
  • Phone: 516-321-0312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. PRAKASH PISIPATI
Title or Position: PRESIDENT
Credential:
Phone: 516-321-0312