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General NPI Number Information
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NPI Number | 1801938105
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Entity Type | Organization
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Legal Business Name | NASSAU SURGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 OLD COUNTRY RD SUITE 101
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City | MINEOLA
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State | NY
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Zip | 11501-4198
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Country | US
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Telephone | 516-741-4138
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Fax | 516-294-4301
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Provider Business Mailing Address
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Address Line | 300 OLD COUNTRY AVENUE SUITE 101
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City | MINEOLA
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State | NY
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Zip | 11501
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Country | US
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Telephone | 516-741-4138
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Fax | 516-294-4301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL E KHALIFE
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Credential |
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Telephone | 516-741-4138
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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 |
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License Number State |
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