MEDICARE: NASSAU QUEENS PULMONARY ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1104809813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASSAU QUEENS PULMONARY ASSOCIATES PC

Provider Business Mailing Address
First Line	:	3003 NEW HYDE PARK RD
Second Line	:	SUITE 303
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1214
Country	:	US
Telephone Number	:	516-292-2027
Fax Number	:	516-292-2046

Provider Business Practice Location Address
First Line	:	3003 NEW HYDE PARK RD
Second Line	:	SUITE 303
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1214
Country	:	US
Telephone Number	:	516-292-2027
Fax Number	:	516-292-2046

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	CYNTHIA SOMMA
Credential	:
Telephone Number	:	516-292-2027

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	05/21/2008

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