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General NPI Number Information
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NPI Number | 1528161692
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY ONCOLOGY ASSOCIATION OF LONG ISLAND
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3003 NEW HYDE PARK RD STE 401
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1214
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Country | US
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Telephone | 516-354-5700
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Fax | 516-354-6095
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Provider Business Mailing Address
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Address Line | 3003 NEW HYDE PARK RD STE 401
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1214
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Country | US
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Telephone | 516-354-5700
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Fax | 516-354-6095
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Authorized Official
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Title or Position | PRESIDENT
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Name | NIRMALA K SHEVDE
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Credential | MD
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Telephone | 516-354-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 127252
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License Number State | NY
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