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Queens Nassau Nephrology Services Pllc

Nephrology Physician in Mineola, NY · enumerated 2014 · authorized official Andre Goncharuck, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1770988909

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Registry record

Entity type Organization (Type 2)
Legal business name Queens Nassau Nephrology Services Pllc
Practice address 300 Old Country Road, 111, Mineola, NY, 11501
Phone (516) 745-0500
Fax (516) 745-1534
Enumeration date Oct 30, 2014
Last updated in NPPES Oct 30, 2014

Taxonomy & classification

207RN0300X Nephrology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Andre Goncharuck
Title President
Phone (516) 745-0500

Other identifiers

Identifier Type State Issuer
03340883 Medicaid NY -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Queens Nassau Nephrology Services Pllc?
NPPES lists Andre Goncharuck (President) as the authorized official for this organization.
What is the NPI number for Queens Nassau Nephrology Services Pllc?
The NPI for Queens Nassau Nephrology Services Pllc is 1770988909, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-10-30.