Oedmg Medical PC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OEDMG MEDICAL PC

Practice address

201 Portion Rd Ste B
Ronkonkoma, NY 11779-4172

Phone

(516) 872-7001

Fax

(516) 872-7015

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Daniel Robert Landolphi, MD

Title

Director

Phone

(516) 872-7001

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1578728424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PORTION RD STE B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794172",
            "telephone_number": "516-872-7001",
            "fax_number": "516-872-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PORTION RD STE B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794172",
            "telephone_number": "516-872-7001",
            "fax_number": "516-872-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OEDMG MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "LANDOLPHI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-872-7001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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