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General NPI Number Information
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NPI Number | 1033999008
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Entity Type | Organization
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Legal Business Name | ISWIW, LLC
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1 OLD COUNTRY RD STE 116
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City | CARLE PLACE
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State | NY
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Zip | 11514-1845
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Country | US
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Telephone | 516-907-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 1 OLD COUNTRY RD STE 116
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City | CARLE PLACE
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State | NY
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Zip | 11514-1845
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Country | US
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Telephone | 516-907-2127
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. SHAUN HONG
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Credential |
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Telephone | 917-373-3704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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