Provider Demographics
NPI:1821808411
Name:D-Y ID MEDICAL CONSULTING LLC
Entity type:Organization
Organization Name:D-Y ID MEDICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CONSULTING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCUTARU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-599-1801
Mailing Address - Street 1:31 HAMLIN RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2950
Mailing Address - Country:US
Mailing Address - Phone:646-599-1801
Mailing Address - Fax:
Practice Address - Street 1:31 HAMLIN RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2950
Practice Address - Country:US
Practice Address - Phone:646-599-1801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty