Organization
ISLAND RHEUMATOLOGY AND OSTEOPOROSIS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY GODHWANI MD (RHEUMATOLOGIST/MEDICAL DIRECTOR)
(631) 886-2844
Entity
Organization
Contact information
Practice address
6144 ROUTE 25A STE 13, WADING RIVER, NY 11792
(631) 886-2488
Mailing address
PO BOX 960, PORT JEFFERSON STATION, NY 11776-0813
(917) 224-0905
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03497523
—
NY
Enumeration date
11/22/2017
Last updated
06/21/2018
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