Organization
DWIGHT DE RISI, M.D. FACS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT CARLTON DE RISI M.D. (PRESIDENT)
(516) 487-8888
Entity
Organization
Contact information
Practice address
1010 NORTHERN BLVD, GREAT NECK, NY 11021-5306
(516) 487-8888
(516) 487-8887
Mailing address
1010 NORTHERN BLVD, SUITE 102, GREAT NECK, NY 11021-5306
(516) 487-8888
(516) 487-8887
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
—
—
Other
Enumeration date
01/31/2007
Last updated
10/01/2007
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