| Sunrise Med Plus LLC | |
|
737 Commack Rd Brentwood NY 11717-7407 | |
| (631) 338-5776 | |
| Not Available |
| Full Name | Sunrise Med Plus LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 737 Commack Rd, Brentwood, New York |
| Authorized Official Name and Position | Hector Melgar (CREDENTIALING) |
| Authorized Official Contact | 6313385776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Med Plus LLC 737 Commack Rd Brentwood NY 11717-7407 Ph: (631) 338-5776 | Sunrise Med Plus LLC 737 Commack Rd Brentwood NY 11717-7407 Ph: (631) 338-5776 |
| NPI Number | 1114519238 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 06/24/2026 |
| Certification Date | 06/24/2026 |
| Medicare PECOS PAC ID | 5395127286 |
|---|---|
| Medicare Enrollment ID | O20220809003660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114519238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | () | Primary |
| Provider Name | Sarita K. Dorschug |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811073935 PECOS PAC ID: 4486780954 Enrollment ID: I20100414000233 |
| Provider Name | Danny Fuzaylov |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104100866 PECOS PAC ID: 7810162104 Enrollment ID: I20111215000271 |
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