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General NPI Number Information
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NPI Number | 1235790015
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Entity Type | Organization
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Legal Business Name | NASSAU SPINE TECHNICAL LLC
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 2594 8TH AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-3253
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Country | US
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Telephone | 516-743-9450
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Fax | 516-743-9451
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Provider Business Mailing Address
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Address Line | 2594 8TH AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-3253
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Country | US
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Telephone | 516-743-9450
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Fax | 516-743-9451
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Authorized Official
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Title or Position | BILLER
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Name | MS. ARIEL LEACH
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Credential |
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Telephone | 516-743-9450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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