Provider Demographics
NPI:1932846763
Name:NORTHSTAR MEDICAL CARE PC
Entity type:Organization
Organization Name:NORTHSTAR MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-992-8049
Mailing Address - Street 1:20 MALIBU RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-3826
Mailing Address - Country:US
Mailing Address - Phone:917-992-8049
Mailing Address - Fax:
Practice Address - Street 1:100 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1354
Practice Address - Country:US
Practice Address - Phone:917-992-8049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty