Organization
CEDARHURST MEDICAL ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRIY ELKIN MD (PRESIDENT)
(718) 471-7010
Entity
Organization
Contact information
Practice address
407 BEACH 20TH STREET, FAR ROCKAWAY, NY 11691
(718) 471-7010
(718) 337-1548
Mailing address
407 BEACH 20TH STREET, FAR ROCKAWAY, NY 11691
(718) 471-7010
(718) 337-1548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
079794-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000451701
US HEALTHCARE
NY
01
—
0009388
GHI
NY
05
—
00791846
—
NY
01
—
CEOW024010
BLUE CHOICE
NY
Enumeration date
05/02/2007
Last updated
10/21/2024
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