Dutch Broadway Family Medical Care, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

230045 Issued in NY

Legal business name

DUTCH BROADWAY FAMILY MEDICAL CARE, P.C.

Practice address

2366 Dutch Broadway
Elmont, NY 11003-3508

Phone

(516) 488-8599

NPI assigned

Aug 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Max Noel, M.D.

Title

Owner

Phone

(516) 488-8595

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1013022987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 DUTCH BROADWAY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033508",
            "telephone_number": "516-488-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 DUTCH BROADWAY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033508",
            "telephone_number": "516-488-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTCH BROADWAY FAMILY MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-488-8595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "230045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02624091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dragonfly Cognitive Development and Consulting LLC
• Melissa Drouillard, LPN
• Suza C Dubuisson, R.N.
• Suzette Dubuisson, LPN
• Nancy Candio Duplessy, NURSE PRACTITIONER
• Lorrine Eastman
• Easy Draw Phlebotomy Solutions LLC
• Easy Home Care Services LLC
• Easy Medbills
• Osasu Edebiri-Egharevba

• Family Medicine Physician in Elmont, NY
• Providers in Elmont, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.