Healthcare Provider Details

I. General information

NPI: 1760500854
Provider Name (Legal Business Name): NASSAU COUNTY DEPT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CHARLES LINDBERGH BLVD SUITE 100
UNIONDALE NY
11553-3683
US

IV. Provider business mailing address

60 CHARLES LINDBERGH BLVD SUITE 115
UNIONDALE NY
11553-3683
US

V. Phone/Fax

Practice location:
  • Phone: 516-227-8648
  • Fax: 516-227-8662
Mailing address:
  • Phone: 516-227-8609
  • Fax: 516-227-7079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number232437
License Number StateNY

VIII. Authorized Official

Name: DR. LAWRENCE E EISENSTEIN
Title or Position: COMMISSIONER
Credential: MD
Phone: 516-571-2260