Provider Demographics
NPI:1942621511
Name:DOC AT HOME MEDICAL, P.C.
Entity Type:Organization
Organization Name:DOC AT HOME MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-865-9697
Mailing Address - Street 1:535 5TH AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-8020
Mailing Address - Country:US
Mailing Address - Phone:888-496-5115
Mailing Address - Fax:866-223-7072
Practice Address - Street 1:535 5TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-8020
Practice Address - Country:US
Practice Address - Phone:888-496-5115
Practice Address - Fax:516-612-4975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH61230Medicare UPIN