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General NPI Number Information
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NPI Number | 1093930653
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Entity Type | Organization
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Legal Business Name | LONG ISLAND SPINE & ORTHOPEDICS, PC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 87 WEST OLD COUNTRY RD.
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City | HICKSVILLE
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State | NY
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Zip | 11801
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Country | US
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Telephone | 516-433-1100
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Fax | 516-433-1342
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Provider Business Mailing Address
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Address Line | 87 WEST OLD COUNTRY RD.
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City | HICKSVILLE
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State | NY
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Zip | 11801
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Country | US
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Telephone | 516-433-1100
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Fax | 516-433-1342
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Authorized Official
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Title or Position | CHIEF OFFICER
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Name | PHILIP M RAFIY
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Credential | M.D.
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Telephone | 516-433-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1957381
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License Number State |
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