=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902862048
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COHEN,CARAVELLA,MELTZER,MD'S,P.L.L.C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 MAIN ST SUITE 1
-----------------------------------------------------
City | HUNTINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11743-6922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-423-0044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 MAIN ST SUITE 1
-----------------------------------------------------
City | HUNTINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11743-6922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-423-0044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. JOYCE BITTNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 631-423-0044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------