Provider Demographics
NPI:1316710650
Name:LONG ISLAND RHEUMATOLOGY PLLC
Entity type:Organization
Organization Name:LONG ISLAND RHEUMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-400-4906
Mailing Address - Street 1:6298 WOODHAVEN BLVD STE S7
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3352
Mailing Address - Country:US
Mailing Address - Phone:917-400-4906
Mailing Address - Fax:
Practice Address - Street 1:6298 WOODHAVEN BLVD STE S7
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3352
Practice Address - Country:US
Practice Address - Phone:917-400-4906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty