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General NPI Number Information
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NPI Number | 1174302871
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Entity Type | Organization
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Legal Business Name | OPTUM MEDICAL CARE, P.C.
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 205 E MAIN ST STE 1-8
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City | HUNTINGTON
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State | NY
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Zip | 11743-7928
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Country | US
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Telephone | 631-427-1500
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Fax | 631-427-2134
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Provider Business Mailing Address
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Address Line | 110 S BEDFORD RD
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3446
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Country | US
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Telephone | 914-241-1050
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Fax | 914-242-1516
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD P MOREL
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Credential | MD
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Telephone | 914-242-2940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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