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Contact Information

BRUCE A FASTENBERG MD PLLC
260 WEST BROADWAY
SUITE 6F
LONG BEACH, NY11561
 Phone: 917-838-5680
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for BRUCE A FASTENBERG MD PLLC

NPI Number 1407944275
LBN Legal business name BRUCE A FASTENBERG MD PLLC
Authorized official BRUCE FASTENBERG - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2006
Last updated 12/26/2014 - About 11 years ago
Identifiers
NY License # 210692
NY Medicaid 02191073
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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