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General NPI Number Information
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NPI Number | 1508267113
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Entity Type | Organization
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Legal Business Name | QUEENS NASSAU PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 26619 UNION TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1426
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Country | US
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Telephone | 917-412-0243
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SUNSET RD N
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City | ALBERTSON
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State | NY
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Zip | 11507-1132
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Country | US
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Telephone | 917-412-0243
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDIP P SHETH
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Credential | M.D.
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Telephone | 516-216-4108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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