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
—
—
Other
Enumeration date
04/17/2021
Last updated
12/09/2022
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