Healthcare Provider Details

I. General information

NPI: 1689960320
Provider Name (Legal Business Name): DORADO MEDICAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 3RD AVE
BRONX NY
10451-4857
US

IV. Provider business mailing address

3055 3RD AVE
BRONX NY
10451-4857
US

V. Phone/Fax

Practice location:
  • Phone: 718-665-1000
  • Fax: 347-577-1030
Mailing address:
  • Phone: 718-665-1000
  • Fax: 347-577-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number207274
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number207274
License Number StateNY

VIII. Authorized Official

Name: ALEXANDER VEDER
Title or Position: OWNER
Credential:
Phone: 646-522-3664