Organization
DIABETES & METABOLISM LLC
Active
Parent organization
EVIDENCE-BASED MEDICINE INC
Other names
Diabetes & Metabolism PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVIDENCE-BASED MEDICINE INC
Authorized official
DR. RONALD J INNERFIELD M.D. (SOLE OFFICER)
(516) 801-0170
Entity
Organization
Contact information
Practice address
29 GLEN COVE AVE, SUITE 108, GLEN COVE, NY 11542-2831
(516) 801-0170
(845) 230-6639
Mailing address
PO BOX 54, AUSTERLITZ, NY 12017-0054
(518) 392-2339
(845) 230-6639
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
118187
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063457950
NPI (INDIVIDUAL)
NY
01
—
3X7921
MEDICARE PTAN
NY
Enumeration date
12/26/2012
Last updated
08/02/2013
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