MEDICARE: DR. HEMA DAVE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25MB05869900	NJ
2	207Q00000X	Family Medicine Physician	196457	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265437339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEMA DAVE D.O.

Provider Business Mailing Address
First Line	:	4 JOYCE PLZ
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-2700
Country	:	US
Telephone Number	:	845-942-5203
Fax Number	:	845-942-5363

Provider Business Practice Location Address
First Line	:	4 JOYCE PLZ
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-2700
Country	:	US
Telephone Number	:	845-942-5203
Fax Number	:	845-942-5363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	01/08/2025

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