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General NPI Number Information
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NPI Number | 1619458932
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Entity Type | Organization
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Legal Business Name | NASSAU HEALTH CONSULTANTS CORP
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 300 GARDEN CITY PLZ STE 330
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City | GARDEN CITY
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State | NY
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Zip | 11530-3331
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Country | US
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Telephone | 516-268-3026
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Fax | 516-268-5122
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Provider Business Mailing Address
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Address Line | 300 GARDEN CITY PLZ STE 330
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City | GARDEN CITY
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State | NY
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Zip | 11530-3331
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Country | US
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Telephone | 516-268-3026
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Fax | 516-268-5122
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Authorized Official
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Title or Position | MEDICAL DIRECTOR, OWNER
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Name | DR. JAY R SHAYEVITZ
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Credential | MD MS
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Telephone | 516-268-3026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | 143091
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License Number State | NY
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