Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Queens Nassau Nephrology Services PLLC

Organization Internal Medicine Physician · NPI 1992934467

Queens Nassau Nephrology Services PLLC is an Internal Medicine Physician in Mineola, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Old Country Road 111
Mineola, NY 11501-4112
Phone: (516) 745-0500
Fax: (516) 745-1534
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X (NY)
Internal Medicine Physician Taxonomy 207R00000X (NY)
Nephrology Physician Taxonomy 207RN0300X · Licence 199896 (NY)

Record details

NPI number1992934467
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrey Goncharuk — President · (516) 745-0500
NPI enumeratedJuly 6, 2009
Last updated in NPPESDecember 5, 2014
Mailing address300 Old Country Road, 111, Mineola, NY 11501-4112

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