Provider Demographics
NPI:1518292531
Name:DAG MEDICAL, PC
Entity Type:Organization
Organization Name:DAG MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREUNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-781-8100
Mailing Address - Street 1:2314 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5627
Mailing Address - Country:US
Mailing Address - Phone:516-781-8100
Mailing Address - Fax:516-781-8133
Practice Address - Street 1:3411 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-5704
Practice Address - Country:US
Practice Address - Phone:516-781-8100
Practice Address - Fax:516-781-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247175208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty