Provider Demographics
NPI:1699965848
Name:CENTRAL NASSAU PEDIATRICS, P.C.
Entity type:Organization
Organization Name:CENTRAL NASSAU PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HONIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-731-8050
Mailing Address - Street 1:3601 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1375
Mailing Address - Country:US
Mailing Address - Phone:516-731-8050
Mailing Address - Fax:516-731-0310
Practice Address - Street 1:3601 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 416
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1375
Practice Address - Country:US
Practice Address - Phone:516-731-8050
Practice Address - Fax:516-731-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131101302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization