Healthcare Provider Details

I. General information

NPI: 1689348278
Provider Name (Legal Business Name): C DOC MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PINE WOODS RD STE 5
HYDE PARK NY
12538-1650
US

IV. Provider business mailing address

7 PINE WOODS RD STE 5
HYDE PARK NY
12538-1650
US

V. Phone/Fax

Practice location:
  • Phone: 631-358-6031
  • Fax: 845-231-6367
Mailing address:
  • Phone: 845-315-4425
  • Fax: 845-231-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA M ANTOINE
Title or Position: CO FOUNDER
Credential: MD
Phone: 845-315-4425