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General NPI Number Information
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NPI Number | 1679450829
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Entity Type | Organization
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Legal Business Name | NASSAU SUFFOLK MEDICAL PLLC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 125 SUNRISE HWY
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City | WEST ISLIP
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State | NY
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Zip | 11795-2023
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Country | US
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Telephone | 631-983-4084
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Fax | 631-983-4085
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Provider Business Mailing Address
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Address Line | 266 BANGOR ST
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City | LINDENHURST
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State | NY
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Zip | 11757-3633
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Country | US
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Telephone | 631-983-4084
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Fax | 631-983-4085
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN SCHWARTZ
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Credential |
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Telephone | 631-478-4388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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