Provider Demographics
NPI:1013188986
Name:ARTHUR R DOVE MD PC
Entity Type:Organization
Organization Name:ARTHUR R DOVE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-876-8655
Mailing Address - Street 1:25 ODONNELL ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2728
Mailing Address - Country:US
Mailing Address - Phone:212-876-8655
Mailing Address - Fax:212-876-4545
Practice Address - Street 1:85 W 118TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-1903
Practice Address - Country:US
Practice Address - Phone:212-876-8655
Practice Address - Fax:212-876-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01675290Medicaid
NY193836A85OtherHEALTHFIRST
NY65S271OtherEMPIRE BLUE CROSS BLUE SHIELD
NY5588651OtherAETNA
NY163691OtherELDERPLAN
NY2594026OtherGHI
NYP2053741OtherOXFORD
NY1000000108OtherAFFINITY
NY211911OtherWELLCARE
NY193836A85OtherHEALTHFIRST
NY=========01Other1199
NY=========OtherTRICARE
NYP2053741OtherOXFORD
NY2594026OtherGHI
NY5588651OtherAETNA