Healthcare Provider Details

I. General information

NPI: 1487619839
Provider Name (Legal Business Name): ELDON STEVEN DUMMIT III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ADAMS STREET
BEDFORD HILLS NY
10507-2001
US

IV. Provider business mailing address

228 LINDA AVE
HAWTHORNE NY
10532-2050
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-0758
  • Fax: 914-242-5152
Mailing address:
  • Phone: 914-773-7423
  • Fax: 914-773-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number171317
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: