NPIMap

Organization Active NPI

D.a.C. Physical Medicine, P.C.

Doing business as North Shore Rehab Medicine

  • Physical Medicine & Rehabilitation Physician
  • Great Neck, NY
National Provider Identifier
1871821504
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
229782 Issued in NY
Legal business name
D.A.C. PHYSICAL MEDICINE, P.C.
Doing business as
North Shore Rehab Medicine
Practice address
55 Northern Blvd
Suite 103
Great Neck, NY 11021-4058
Phone
(516) 466-9300
Fax
(516) 466-9353
NPI assigned
Nov 18, 2009
Last updated
Nov 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Dale Alexander, D.O
Title
Owner
Phone
(516) 466-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 229782 NY Primary

Addresses

Primary practice location

55 Northern Blvd
Suite 103
Great Neck, NY 11021-4058

Mailing address

55 Northern Blvd
Suite 103
Great Neck, NY 11021-4058
Phone (516) 466-9300

Other names 1

  • North Shore Rehab Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

55 Northern Blvd
#103
Great Neck, NY 11021
Phone (516) 466-9300

Practitioners & affiliated clinicians

Practitioners 12

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": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1871821504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NORTHERN BLVD",
            "address_2": "SUITE 103",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214058",
            "telephone_number": "516-466-9300",
            "fax_number": "516-466-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NORTHERN BLVD",
            "address_2": "SUITE 103",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214058",
            "telephone_number": "516-466-9300",
            "fax_number": "516-466-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.A.C. PHYSICAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-466-9300",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "229782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Rehab Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.