QUEENS NASSAU NEPHROLOGY SERVICES PLLC NPI 1992934467

NPI Information

  • NPI: 1992934467
  • Provider Name: QUEENS NASSAU NEPHROLOGY SERVICES PLLC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Address: 300 OLD COUNTRY ROAD
    111
    MINEOLA, NY
    ZIP 11501
  • Phone: (516) 745-0500

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NPI Details

QUEENS NASSAU NEPHROLOGY SERVICES PLLC is a nephrology internal medicine in Mineola, NY. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. QUEENS NASSAU NEPHROLOGY SERVICES PLLC NPI is 1992934467. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 OLD COUNTRY ROAD
111
MINEOLA, NY
ZIP 11501-112
Phone: (516) 745-0500
Fax: (516) 745-1534

The provider's authorized official is Andrey Goncharuk .
The authorized official title is President and has the following contact phone number (516) 745-0500.

The enumeration date for this NPI number is 7/6/2009 and was last updated on 12/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrology199896NEW YORKNo
2207R00000XInternal MedicineNEW YORKNo
3207RN0300XInternal MedicineNephrologyNEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A100023879MEDICARE PIN
2A100023879MEDICARE PINNEW YORK
303340883MEDICAIDNEW YORK
4G100121495MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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