Provider Demographics
NPI:1154423622
Name:AMITYVILLE PULMONOLOGY PLLC
Entity type:Organization
Organization Name:AMITYVILLE PULMONOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANIJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-598-5864
Mailing Address - Street 1:317 BROADWAY STE A
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2709
Mailing Address - Country:US
Mailing Address - Phone:631-598-5864
Mailing Address - Fax:631-598-5866
Practice Address - Street 1:317 BROADWAY STE A
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2709
Practice Address - Country:US
Practice Address - Phone:631-598-5864
Practice Address - Fax:631-598-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty