Provider Demographics
NPI:1275312977
Name:OPTUM MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:OPTUM MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:MOREL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-242-2940
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:575 UNDERHILL BLVD STE 190
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3494
Practice Address - Country:US
Practice Address - Phone:516-210-8840
Practice Address - Fax:516-210-8842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTUM MEDICAL CARE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies