Dr Indravadan Dave, MD | |
2090 Jericho Tpke, New Hyde Park, NY 11040-4719 | |
(513) 352-7828 | |
(516) 352-7827 |
Full Name | Dr Indravadan Dave |
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Gender | Male |
Speciality | General Practice |
Location | 2090 Jericho Tpke, New Hyde Park, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497799944 | NPI | - | NPPES |
00C418760 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | C41876 (California) | Secondary |
207R00000X | Internal Medicine | C41876 (California) | Secondary |
208D00000X | General Practice | 109643 (New York) | Primary |
Entity Name | Dhhs,phs,naihs, Gallup Indian Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225002322 PECOS PAC ID: 3173436409 Enrollment ID: O20031111000840 |
Mailing Address | Practice Location Address |
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Dr Indravadan Dave, MD 2090 Jericho Tpke, New Hyde Park, NY 11040-4719 Ph: (513) 352-7828 | Dr Indravadan Dave, MD 2090 Jericho Tpke, New Hyde Park, NY 11040-4719 Ph: (513) 352-7828 |
Dr. Russell James Pepe, MD General Practice Medicare: Medicare Enrolled Practice Location: 27005 76th Ave, New Hyde Park, NY 11040 Phone: 718-470-4475 Fax: 718-962-2239 | |
Avital E Friedman, General Practice Medicare: Accepting Medicare Assignments Practice Location: 1999 Marcus Ave, New Hyde Park, NY 11042 Phone: 516-233-3780 | |
Patti G Weinberg, PA General Practice Medicare: Not Enrolled in Medicare Practice Location: 1979 Marcus Ave, New Hyde Park, NY 11042 Phone: 516-209-5537 |