Dec Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DEC MEDICAL PC

Practice address

149 Woodmere Blvd S
Woodmere, NY 11598-1845

Phone

(516) 200-6441

Fax

(516) 612-2267

NPI assigned

Sep 4, 2019

Organization subpart

No

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

Authorized official

Name

Angela Otano

Title

Billing Manager

Phone

(718) 306-9769

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1497304364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 WOODMERE BLVD S",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981845",
            "telephone_number": "516-200-6441",
            "fax_number": "516-612-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 WOODMERE BLVD S",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981845",
            "telephone_number": "516-200-6441",
            "fax_number": "516-612-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEC MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "OTANO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "718-306-9769"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Hope Davanzo, LCSWR
• David Lutz Physician Assistant PLLC
• David S. Rosenthal, DC, PLLC
• Rebbeca Davies
• Nautica Renee Deal
• Yisely Del Valle Orozco
• Jenna Delia
• Juanita Dew
• Francine Diamond
• Serach M Diamond

• Internal Medicine Physician in Woodmere, NY
• Providers in Woodmere, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.