NPIMap

Organization Active NPI

Bellmore-Wantagh Adult Medicine, PLLC

  • Internal Medicine Physician
  • Wantagh, NY
National Provider Identifier
1306012489
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BELLMORE-WANTAGH ADULT MEDICINE, PLLC
Practice address
2857 Jerusalem Ave
Wantagh, NY 11793-2018
Phone
(516) 785-2783
Fax
(516) 785-2584
NPI assigned
May 7, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Dr. Eric C. Last, DONPI 1528097367
Title
Principal
Phone
(516) 785-2783

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2857 Jerusalem Ave
Wantagh, NY 11793-2018

Mailing address

2857 Jerusalem Ave
Wantagh, NY 11793-2018
Phone (516) 785-2783

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1306012489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 JERUSALEM AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932018",
            "telephone_number": "516-785-2783",
            "fax_number": "516-785-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 JERUSALEM AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932018",
            "telephone_number": "516-785-2783",
            "fax_number": "516-785-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLMORE-WANTAGH ADULT MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "LAST",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "516-785-2783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.