Healthcare Provider Details

I. General information

NPI: 1518292531
Provider Name (Legal Business Name): DAG MEDICAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 WHITE PLAINS RD
BRONX NY
10467-5704
US

IV. Provider business mailing address

2314 BELLMORE AVE
BELLMORE NY
11710-5627
US

V. Phone/Fax

Practice location:
  • Phone: 516-781-8100
  • Fax: 516-781-8133
Mailing address:
  • Phone: 516-781-8100
  • Fax: 516-781-8133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number247175
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID A GREUNER
Title or Position: OWNER
Credential: M.D.
Phone: 516-781-8100