CEDARHURST MEDICAL ASSOCIATES P.C. NPI 1053532234

NPI Information

NPI: 1053532234
Provider Name: CEDARHURST MEDICAL ASSOCIATES P.C.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
CLIA Number: 33D0877010
Address: 407 BEACH 20TH STREET
FAR ROCKAWAY, NY
ZIP 11691
Phone: (718) 471-7010

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NPI Details

CEDARHURST MEDICAL ASSOCIATES P.C. is an internal medicine in Far Rockaway, NY. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CEDARHURST MEDICAL ASSOCIATES P.C. NPI is 1053532234. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

407 BEACH 20TH STREET
FAR ROCKAWAY, NY
ZIP 11691
Phone: (718) 471-7010
Fax: (718) 337-1548

The provider's authorized official is Dmitriy Elkin .
The authorized official title is President and has the following contact phone number (718) 471-7010.

The CLIA number assigned to this NPI record is 33D0877010 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2007 and was last updated on 10/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		079794-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0009388	OTHER	NEW YORK	GHI
2	000451701	OTHER	NEW YORK	US HEALTHCARE
3	CEOW024010	OTHER	NEW YORK	BLUE CHOICE
4	00791846	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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