Deer Park Medical, P.C.

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

DEER PARK MEDICAL, P.C.

Practice address

2103 Deer Park Ave
Deer Park, NY 11729-1317

Phone

(631) 302-5700

NPI assigned

Jan 20, 2020

Organization subpart

No

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

Authorized official

Name

William Roberto Lopez

Title

Office Manager

Phone

(631) 302-5700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1285264192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-302-5700",
            "fax_number": "631-918-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-302-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERTO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-302-5700"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Body Imaging Physician in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Body Imaging Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.