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General NPI Number Information
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NPI Number | 1033375878
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Entity Type | Organization
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Legal Business Name | DOCTORS COMMUNITY MEDICAL GROUP LLC
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 8118 GOOD LUCK RD
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City | LANHAM
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State | MD
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Zip | 20706-3574
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Country | US
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Telephone | 607-324-2340
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Fax | 607-324-7615
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Provider Business Mailing Address
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Address Line | 32 BROADWAY MALL
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City | HORNELL
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State | NY
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Zip | 14843-1920
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Country | US
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Telephone | 607-324-2340
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Fax | 607-324-7615
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CHESTER DILALLO
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Credential | M.D.
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Telephone | 607-324-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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