Provider Demographics
NPI:1104121631
Name:GET WELL MEDICAL CARE OF LONG ISLAND, P.C.
Entity type:Organization
Organization Name:GET WELL MEDICAL CARE OF LONG ISLAND, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-422-4448
Mailing Address - Street 1:184 E MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3529
Mailing Address - Country:US
Mailing Address - Phone:631-422-4448
Mailing Address - Fax:
Practice Address - Street 1:184 E MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3529
Practice Address - Country:US
Practice Address - Phone:631-422-4448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF10524Medicare UPIN