Provider Demographics
NPI:1497925291
Name:MED-ONE CARE, LLC
Entity Type:Organization
Organization Name:MED-ONE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:OKONTA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:914-217-6309
Mailing Address - Street 1:217-14 MERRICK BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LAUELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413
Mailing Address - Country:US
Mailing Address - Phone:914-217-6309
Mailing Address - Fax:
Practice Address - Street 1:4 TALON WAY
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6239
Practice Address - Country:US
Practice Address - Phone:914-217-6309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177073207P00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty