Provider Demographics
NPI:1366793671
Name:JOSEPH C DREYFUS III MD PC
Entity type:Organization
Organization Name:JOSEPH C DREYFUS III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:DREYFUS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:212-288-9444
Mailing Address - Street 1:215 E 68TH ST
Mailing Address - Street 2:SUITE # 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5718
Mailing Address - Country:US
Mailing Address - Phone:212-288-9444
Mailing Address - Fax:212-535-0692
Practice Address - Street 1:215 E 68TH ST
Practice Address - Street 2:SUITE # 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5718
Practice Address - Country:US
Practice Address - Phone:212-288-9444
Practice Address - Fax:212-535-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104221207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY626511OtherMEDICARE IDENTIFICATION NUMBER
NYC11588Medicare UPIN