New York Direct Medical Pllc | |
979 Ulster Heights Rd Ellenville NY 12428-5746 | |
(718) 795-4443 | |
Not Available |
Full Name | New York Direct Medical Pllc |
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Speciality | Internal Medicine |
Location | 979 Ulster Heights Rd, Ellenville, New York |
Authorized Official Name and Position | Alexander Roth (MD) |
Authorized Official Contact | 7182505000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New York Direct Medical Pllc 979 Ulster Heights Rd Ellenville NY 12428-5746 Ph: () - | New York Direct Medical Pllc 979 Ulster Heights Rd Ellenville NY 12428-5746 Ph: (718) 795-4443 |
NPI Number | 1497570907 |
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Provider Enumeration Date | 11/19/2024 |
Last Update Date | 02/10/2025 |
Medicare PECOS PAC ID | 1355861345 |
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Medicare Enrollment ID | O20250220002339 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497570907 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Alexander Roth |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215310925 PECOS PAC ID: 8921352097 Enrollment ID: I20181109000128 |
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