Healthcare Provider Details

I. General information

NPI: 1255636114
Provider Name (Legal Business Name): LONG ISLAND OSTEOPOROSIS & ARTHRITIS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 OLD COUNTRY RD
PLAINVIEW NY
11803-6502
US

IV. Provider business mailing address

524 OLD COUNTRY RD
PLAINVIEW NY
11803-6502
US

V. Phone/Fax

Practice location:
  • Phone: 516-931-3988
  • Fax: 516-931-4091
Mailing address:
  • Phone: 516-931-3988
  • Fax: 516-931-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number014714
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name: PREM CHATPAR
Title or Position: MEDICAL ADMINISTRATOR
Credential: M.D.
Phone: 516-931-3988