Provider Demographics
NPI:1881951820
Name:SUNRISE MEDICAL CARE SERVICES PC
Entity type:Organization
Organization Name:SUNRISE MEDICAL CARE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-766-0393
Mailing Address - Street 1:165 N VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3761
Mailing Address - Country:US
Mailing Address - Phone:516-766-0393
Mailing Address - Fax:
Practice Address - Street 1:165 NORTH VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTER
Practice Address - State:NY
Practice Address - Zip Code:11570-0000
Practice Address - Country:US
Practice Address - Phone:516-766-0393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty