# HEALTH 1 MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639124571
- **Authorized official:** GARY DICANIO DO (OWNER)
- **Authorized official phone:** (631) 580-1000

## Contact information

- **Practice address:** 2780 MIDDLE COUNTRY RD, SUITE 140, LAKE GROVE, NY 11755-2124
- **Practice address phone:** (631) 580-1000
- **Practice address fax:** (631) 580-0483
- **Mailing address:** 2780 MIDDLE COUNTRY RD, SUITE 140, LAKE GROVE, NY 11755-2124
- **Mailing address phone:** (631) 580-1000
- **Mailing address fax:** (631) 580-0483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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