Provider Demographics
NPI:1447343983
Name:LONG ISLAND MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:LONG ISLAND MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-422-7200
Mailing Address - Street 1:393 SUNRISE HWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-5909
Mailing Address - Country:US
Mailing Address - Phone:631-422-7200
Mailing Address - Fax:
Practice Address - Street 1:393 SUNRISE HWY
Practice Address - Street 2:SUITE 7
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-5909
Practice Address - Country:US
Practice Address - Phone:631-422-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center