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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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