Healthcare Provider Details

I. General information

NPI: 1780068700
Provider Name (Legal Business Name): ISLANDWIDE DSH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 FORT SALONGA RD SUITE 3
NORTHPORT NY
11768-3044
US

IV. Provider business mailing address

1 HIGH HEDGES CT
SAINT JAMES NY
11780-1409
US

V. Phone/Fax

Practice location:
  • Phone: 516-672-0998
  • Fax:
Mailing address:
  • Phone: 516-672-0998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2279E1000X
TaxonomyEducational Registered Respiratory Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2279P1006X
TaxonomyPulmonary Function Technologist Registered Respiratory Therapist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MOUNTASER KHALIFA
Title or Position: PRESIDENT
Credential:
Phone: 516-672-0998