Provider Demographics
NPI:1417177569
Name:RHEE, DAVID Y (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Y
Last Name:RHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NORTHERN BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5200
Mailing Address - Country:US
Mailing Address - Phone:516-466-0390
Mailing Address - Fax:516-466-4956
Practice Address - Street 1:600 NORTHERN BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5200
Practice Address - Country:US
Practice Address - Phone:516-466-0390
Practice Address - Fax:516-466-4956
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431478207W00000X
NY253220207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03176510Medicaid
PA1019752220001Medicaid
NYW8E001Medicare PIN
PA112453QXPMedicare PIN
NYA400022801Medicare PIN
PAH41115Medicare UPIN
PA1019752220001Medicaid
NYG400012631Medicare PIN
NYP00806620Medicare PIN