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Organization
HEALTH 1 MEDICAL PC
Active
Organization
HEALTH 1 MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY DICANIO DO (OWNER)
(631) 580-1000
Entity
Organization
Contact information
Practice address
2780 MIDDLE COUNTRY RD, SUITE 140, LAKE GROVE, NY 11755-2124
(631) 580-1000
(631) 580-0483
Mailing address
2780 MIDDLE COUNTRY RD, SUITE 140, LAKE GROVE, NY 11755-2124
(631) 580-1000
(631) 580-0483
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/22/2006
Last updated
06/18/2008
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