Provider Demographics
NPI:1932846763
Name:NORTHSTAR MEDICAL CARE PC
Entity Type:Organization
Organization Name:NORTHSTAR MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-992-8049
Mailing Address - Street 1:665 TREEHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095-6837
Mailing Address - Country:US
Mailing Address - Phone:904-654-2410
Mailing Address - Fax:
Practice Address - Street 1:100 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1354
Practice Address - Country:US
Practice Address - Phone:904-654-2410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty