Organization
LONG ISLAND HYPERTENSION AND NEPHROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIONEL U MAILLOUX MD (MANAGING MEMBER)
(516) 484-6093
Entity
Organization
Contact information
Practice address
50 SEAVIEW BLVD, PORT WASHINGTON, NY 11050-4618
(516) 484-6093
(516) 484-6180
Mailing address
50 SEAVIEW BLVD, PORT WASHINGTON, NY 11050-4618
(516) 484-6093
(516) 484-6180
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W38161
MEDICARE GROUP NUMBER
NY
Enumeration date
05/31/2006
Last updated
05/01/2008
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