Healthcare Provider Details

I. General information

NPI: 1114961968
Provider Name (Legal Business Name): HAIM BRANDSPIEGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 OLD COUNTRY RD
PLAINVIEW NY
11803-4907
US

IV. Provider business mailing address

4277 HEMPSTEAD TPKE SUITE 209
BETHPAGE NY
11714-5709
US

V. Phone/Fax

Practice location:
  • Phone: 516-433-3600
  • Fax: 516-433-9490
Mailing address:
  • Phone: 516-731-7770
  • Fax: 516-731-7052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number197387
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01951142
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 2
IdentifierP0012184
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerRAILROAD MEDICARE
# 3
IdentifierP1859509
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerOXFORD
# 4
Identifier3C6620
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerHEALTHNET

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: