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General NPI Number Information
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NPI Number | 1306177365
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Entity Type | Organization
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Legal Business Name | WELLCORE MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 34 LINDBERGH CIR
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City | HUNTINGTON
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State | NY
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Zip | 11743-5367
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Country | US
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Telephone | 631-356-5412
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Fax | 631-918-7119
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Provider Business Mailing Address
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Address Line | PO BOX 29219
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City | NEW YORK
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State | NY
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Zip | 10087-9219
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Country | US
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Telephone | 631-356-5412
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Fax | 631-918-7119
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. ALI SALIMI
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Credential | MD
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Telephone | 631-356-5412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 194072
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 194072
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License Number State | NY
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