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General NPI Number Information
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NPI Number | 1720266356
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Entity Type | Organization
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Legal Business Name | ISLAND ONCOLOGY HEMATOLOGY ASSOCIATES,P.C.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 3601 HEMPSTEAD TPKE SUITE 421
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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 | 516-796-1500
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Fax | 516-579-1905
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Provider Business Mailing Address
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Address Line | 3601 HEMPSTEAD TPKE SUITE 421
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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 | 516-796-1500
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LYNN STAUDTER
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Credential |
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Telephone | 516-796-1500
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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 | 095557
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License Number State | NY
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