Provider Demographics
NPI:1841552312
Name:DACMEDICINE, PC
Entity type:Organization
Organization Name:DACMEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:CLAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-313-4690
Mailing Address - Street 1:865 MERRICK RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3338
Mailing Address - Country:US
Mailing Address - Phone:516-442-4728
Mailing Address - Fax:
Practice Address - Street 1:865 MERRICK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3338
Practice Address - Country:US
Practice Address - Phone:516-442-4728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159980208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty