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Organization
WELLCARE MEDICAL OF LONG ISLAND PLLC
Active
Organization
WELLCARE MEDICAL OF LONG ISLAND PLLC
Active
Other names
Pure Medical
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN B. SHAPIRO MD (OWNER)
(516) 680-3900
Entity
Organization
Contact information
Practice address
85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
(516) 412-7873
Mailing address
1300 UNION TPKE STE 206, NEW HYDE PARK, NY 11040-1759
(516) 680-3900
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/17/2021
Last updated
12/09/2022
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