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General NPI Number Information
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NPI Number | 1417271156
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PAIN CARE PLLC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 3601 HEMPSTEAD TPKE SUITE 206
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City | LEVITTOWN
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State | NY
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Zip | 11756-1375
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Country | US
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Telephone | 516-735-7246
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Fax | 516-735-7248
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Provider Business Mailing Address
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Address Line | 3601 HEMPSTEAD TPKE SUITE 206
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City | LEVITTOWN
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State | NY
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Zip | 11756-1375
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Country | US
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Telephone | 516-735-7246
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Fax | 516-735-7248
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Authorized Official
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Title or Position | OWNER
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Name | DR. NOLAN DAVID TZOU
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Credential | M.D
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Telephone | 516-735-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A1865711
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License Number State | NY
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