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Organization
EASTERN SUFFOLK NEPHROLOGY PC
Active
Organization
EASTERN SUFFOLK NEPHROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PURSHOTAM LAL NAGWANI M.D. (OWNER)
(631) 727-5112
Entity
Organization
Contact information
Practice address
758 HARRISON AVE, RIVERHEAD, NY 11901-2744
(631) 727-5112
Mailing address
758 HARRISON AVE, RIVERHEAD, NY 11901-2744
(631) 727-5112
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
143580
NY
Other
Enumeration date
01/23/2007
Last updated
08/08/2008
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