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General NPI Number Information
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NPI Number | 1235066408
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Entity Type | Organization
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Legal Business Name | PA SNF PHYSICIANS PLLC
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 48 FROST LN UNIT A
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City | LAWRENCE
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State | NY
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Zip | 11559-1806
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Country | US
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Telephone | 516-862-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 48 FROST LN UNIT A
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City | LAWRENCE
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State | NY
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Zip | 11559-1806
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YEHUDA NUSSBAUM
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Credential | DO
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Telephone | 347-672-8397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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