Healthcare Provider Details

I. General information

NPI: 1215019377
Provider Name (Legal Business Name): EXPERT MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 -14, SUITE 210 FRANCIS LEWIS BLVD, ST ALBANS
NEW YORK NY
11412
US

IV. Provider business mailing address

246-07 136TH ROAD ROSEDALE, QUEENS
ROSEDALE NY
11422
US

V. Phone/Fax

Practice location:
  • Phone: 718-276-7935
  • Fax:
Mailing address:
  • Phone: 718-276-2932
  • Fax: 718-528-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. JEAN LOUIS MAX DUPITON
Title or Position: MD
Credential: MD
Phone: 718-276-7935