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Organization
DEER PARK MEDICAL, P.C.
Active
Organization
DEER PARK MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DEMISHEV M.D. (PC OWNER)
(631) 242-4500
Entity
Organization
Contact information
Practice address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 617-6633
Mailing address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 617-6633
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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