Provider Demographics
NPI:1720446081
Name:ISLAND PULMONARY AND SLEEP CENTER INC
Entity type:Organization
Organization Name:ISLAND PULMONARY AND SLEEP CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHINY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-8574
Mailing Address - Street 1:219 BETTE RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1302
Mailing Address - Country:US
Mailing Address - Phone:718-200-8574
Mailing Address - Fax:718-322-1322
Practice Address - Street 1:1905 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1047
Practice Address - Country:US
Practice Address - Phone:718-200-8574
Practice Address - Fax:718-322-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty