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General NPI Number Information
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NPI Number | 1417835034
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Entity Type | Organization
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Legal Business Name | DE MEDICAL NY PC
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 83 HAMLET DR
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City | COMMACK
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State | NY
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Zip | 11725-4441
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Country | US
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Telephone | 631-372-8456
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Fax |
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Provider Business Mailing Address
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Address Line | 83 HAMLET DR
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City | COMMACK
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State | NY
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Zip | 11725-4441
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Country | US
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Telephone | 631-372-8456
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS ELWOOD
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Credential | MD
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Telephone | 631-372-8456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0404X
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Taxonomy Name | Cardiac Rehabilitation Clinic/Center
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License Number |
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License Number State |
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