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General NPI Number Information
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NPI Number | 1700296340
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC AND INTERVENTIONAL MEDICAL CARE P.C.
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 1 ARROWOOD LN
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City | MELVILLE
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State | NY
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Zip | 11747-1503
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Country | US
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Telephone | 631-546-5081
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Fax | 631-956-8355
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Provider Business Mailing Address
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Address Line | 1 ARROWOOD LN
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City | MELVILLE
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State | NY
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Zip | 11747-1503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | ANIL PATIL
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Credential |
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Telephone | 631-546-5081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 105157
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 105157
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License Number State | NY
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