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EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION NPI 1205234291


NPI Information

NPI: 1205234291
Provider Name: EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION

Former Legal Business Name: DIRK WALES MD PC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
555 BROADHOLLOW RD STE 305
MELVILLE, NY
ZIP 11747
Phone: (773) 292-4800
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EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION is a family medicine in Melville, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EVERNORTH MEDICAL CARE PROVIDERS NEW YORK PROFESSIONAL CORPORATION NPI is 1205234291. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Dirk Wales Md Pc.

The provider's business location address is:

555 BROADHOLLOW RD STE 305
MELVILLE, NY
ZIP 11747-018
Phone: (773) 292-4800
Fax: (312) 564-4059

The provider's authorized official is Grace Blue .
The authorized official title is Credentialing Sr. Manager and has the following contact phone number (773) 292-4800.

The enumeration date for this NPI number is 12/8/2014 and was last updated on 2/13/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0505XFamily MedicineAdult MedicineNo
2207QH0002XFamily MedicineHospice and Palliative MedicineNo
3207R00000XInternal MedicineNo
4207RH0002XInternal MedicineHospice and Palliative MedicineNo
5213E00000XPodiatristNo
6363L00000XNurse PractitionerNo
7207Q00000XFamily MedicineYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.