MEDICARE: NIGHTWATCH MEDICINE PLLC

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184321739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIGHTWATCH MEDICINE PLLC

Provider Business Mailing Address
First Line	:	20 WESTWOOD CIR
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1823
Country	:	US
Telephone Number	:	718-454-4356
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 DEWBERRY CT
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-5655
Country	:	US
Telephone Number	:	516-643-2513
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	NODAR JANAS
Credential	:	MD
Telephone Number	:	516-643-2513

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	09/25/2025

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Directions to “NIGHTWATCH MEDICINE PLLC ” Practice Location

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