Healthcare Provider Details

I. General information

NPI: 1710008644
Provider Name (Legal Business Name): LONG ISLAND PULMONARY AND SLEEP MEDICINE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VILLAGE AVE SUITE 300
ROCKVILLE CENTRE NY
11570-2341
US

IV. Provider business mailing address

200 N VILLAGE AVE SUITE 300
ROCKVILLE CENTRE NY
11570-2341
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-8151
  • Fax: 516-536-8153
Mailing address:
  • Phone: 516-536-8151
  • Fax: 516-536-8153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number187532
License Number StateNY

VIII. Authorized Official

Name: DR. FRANK SAVERIO COLETTA
Title or Position: PRESIDENT
Credential: MD
Phone: 516-536-8151