# SOUTH NASSAU INTERNAL MEDICINE ASSOCIATES, LLP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508045279
- **Authorized official:** MRS. BARBARA M MARTIN (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (516) 379-3139

## Contact information

- **Practice address:** 155 W MERRICK RD, SUITE 101, FREEPORT, NY 11520-3743
- **Practice address phone:** (516) 379-3139
- **Practice address fax:** (516) 868-0683
- **Mailing address:** 155 W MERRICK RD, SUITE 101, FREEPORT, NY 11520-3743
- **Mailing address phone:** (516) 379-3139
- **Mailing address fax:** (516) 868-0683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 164466 | NY | — |
| 207R00000X | Internal Medicine Physician | F46077 | NY | — |
| 207RC0000X | Cardiovascular Disease Physician | 149408 | NY | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 112891 | NY | Yes |
| 363A00000X | Physician Assistant | 0107171 | NY | — |
| 363LA2200X | Adult Health Nurse Practitioner | F3019041 | NY | — |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 10/31/2007