Provider Demographics
NPI:1265453104
Name:DEWAL, HARGOVIND SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARGOVIND
Middle Name:SINGH
Last Name:DEWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:763 LARKFIELD RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3131
Mailing Address - Country:US
Mailing Address - Phone:631-462-2225
Mailing Address - Fax:631-462-2240
Practice Address - Street 1:763 LARKFIELD RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3131
Practice Address - Country:US
Practice Address - Phone:631-462-2225
Practice Address - Fax:631-462-2240
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY217127207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI14655Medicare UPIN