Provider Demographics
NPI:1023346467
Name:EAST COAST RHEUMATOLOGY PLLC
Entity type:Organization
Organization Name:EAST COAST RHEUMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PREM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHATPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-938-6659
Mailing Address - Street 1:524 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6502
Mailing Address - Country:US
Mailing Address - Phone:516-938-6659
Mailing Address - Fax:516-622-1310
Practice Address - Street 1:524 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6502
Practice Address - Country:US
Practice Address - Phone:516-938-6659
Practice Address - Fax:516-622-1310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREM C CHATPAR MD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-23
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146380207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty