Deer Park Medical, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

DEER PARK MEDICAL, P.C.

Practice address

2103 Deer Park Ave
Deer Park, NY 11729-1319

Phone

(631) 242-4500

Fax

(631) 617-6633

NPI assigned

Mar 14, 2012

Organization subpart

No

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

Authorized official

Name

Michael Demishev, M.D.

Title

PC Owner

Phone

(631) 242-4500

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1518232115",
    "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": "117291319",
            "telephone_number": "631-242-4500",
            "fax_number": "631-617-6633"
        },
        {
            "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": "117291319",
            "telephone_number": "631-242-4500",
            "fax_number": "631-617-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "DEMISHEV",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PC OWNER",
        "authorized_official_telephone_number": "631-242-4500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela J Day, LCSW
• Deer Park Chiropractic and Physical Therapy PLLC
• Deer Park Chiropractic PC
• Deer Park Fire District 14 Inc
• Deer Park Medical, P.C.
• Deer Park Physical Therapy & Chiropractic
• Deer Park Physical Therapy and Chiropractic PLLC
• Deer Park PT & Pta Physical Therapy & Rehabilitation, PLLC
• Deer Park PT, Family Health NP and Chiropractic PLLC
• Deer Park Ufsd

• Physical Medicine & Rehabilitation Physician in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.