Organization
QUEENS NASSAU NEPHROLOGY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROZ KELLY (OFFICE MANAGER)
(516) 745-0500
Entity
Organization
Contact information
Practice address
300 OLD COUNTRY RD, SUITE 111, MINEOLA, NY 11501-4112
(516) 745-0500
(516) 745-1534
Mailing address
300 OLD COUNTRY RD, SUITE 111, MINEOLA, NY 11501-4112
(516) 745-0500
(516) 745-1534
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02757151
—
NY
Enumeration date
05/18/2006
Last updated
03/09/2012
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