Healthcare Provider Details

I. General information

NPI: 1467789206
Provider Name (Legal Business Name): SECOND OPINION MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 STONELEIGH AVE
CARMEL NY
10512-3997
US

IV. Provider business mailing address

670 STONELEIGH AVE SUITE C-122
CARMEL NY
10512-3997
US

V. Phone/Fax

Practice location:
  • Phone: 914-960-8055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: P. CHARLES GARELL
Title or Position: PRESIDENT
Credential:
Phone: 914-960-8055