Provider Demographics
NPI:1952302622
Name:DAVE FAMILY MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:DAVE FAMILY MEDICAL SERVICES PC
Other - Org Name:HIRENDRA DAVE
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:914-633-7200
Mailing Address - Street 1:110 LOCKWOOD AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5028
Mailing Address - Country:US
Mailing Address - Phone:914-633-7200
Mailing Address - Fax:914-633-7217
Practice Address - Street 1:110 LOCKWOOD AVE
Practice Address - Street 2:STE 202
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5028
Practice Address - Country:US
Practice Address - Phone:914-633-7200
Practice Address - Fax:914-633-7217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2G23693OtherCIGNA
5998082OtherGHI PPO
2110971OtherUNITED HEALTHCARE
080182250OtherRAILROAD MEDICARE
P2551679OtherOXFORD
2623693OtherAETNA
NY02164767Medicaid
4C2500OtherHEALTH NET
NY5D8951OtherBCBS
73211OtherGHI-43 HMO
P24111OtherGHI MEDICARE
P24111OtherGHI MEDICARE
2110971OtherUNITED HEALTHCARE