Organization · Type 2 NPI
63 ST Medical Heathcare PC
General Practice Physician · Woodside, NY
NPI number
1396012324
Active
Practice location
3939 63rd St # 1A
Woodside, NY 11377-3648
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 141555 (NY) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1396012324
63 ST Medical Heathcare PC's National Provider Identifier is 1396012324, issued on Nov 18, 2011. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Woodside, NY. The record was last updated on Nov 18, 2011.