Healthcare Provider Details

I. General information

NPI: 1710321070
Provider Name (Legal Business Name): DIRECT MEDICAL SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 33RD ST
ASTORIA NY
11105-2402
US

IV. Provider business mailing address

2231 33RD ST
ASTORIA NY
11105-2402
US

V. Phone/Fax

Practice location:
  • Phone: 516-413-2037
  • Fax:
Mailing address:
  • Phone: 516-413-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number234166-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number222108-1
License Number StateNY

VIII. Authorized Official

Name: MARIA OROZCO
Title or Position: MANAGER
Credential: CREDENTIAL
Phone: 941-766-8995