Dirk Wales Md Pc

LBN: Evernorth Medical Care Providers New York Professional Corporation
Dirk Wales Md Pc is an health care organization with primary practice located at 555 Broadhollow Rd Ste 305 , Melville NY 11747-5018. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Podiatric Medicine & Surgery Service Providers / Podiatrist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Evernorth Medical Care Providers New York Professional Corporation can be contacted via phone (773) 292-4800, or through Blue, Grace via phone (773) 292-4800.

Contact Information

Primary practice address
555 Broadhollow Rd Ste 305 Melville NY 11747-5018
Phone: (773) 292-4800
Fax: (312) 564-4059
Website:
Map and Directions
Authorized official contact:
Name: Blue, Grace
Phone: (773) 292-4800

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1205234291
LBN Legal business name Evernorth Medical Care Providers New York Professional Corporation
DBA Doing business as Dirk Wales Md Pc
Authorized official Blue, Grace
Entity Organization
Organization subpart 1 No
Enumeration date Dec 8th, 2014
Last updated Feb 13th, 2024 - about 10 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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