Healthcare Provider Details

I. General information

NPI: 1548552821
Provider Name (Legal Business Name): JOEL DLUGASH MD & VICTOR DLUGASH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N VILLAGE AVE 115
ROCKVILLE CENTRE NY
11570-3761
US

IV. Provider business mailing address

165 N VILLAGE AVENUE 115
ROCKVILLE CENTRE NY
11570-3761
US

V. Phone/Fax

Practice location:
  • Phone: 516-764-7660
  • Fax: 516-764-7882
Mailing address:
  • Phone: 516-764-7660
  • Fax: 516-764-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number126468
License Number StateNY

VIII. Authorized Official

Name: DR. VICTOR DLUGASH
Title or Position: PRESIDENT
Credential: MD
Phone: 515-764-7660