| Carend Provider Group Of Ny | |
|
191 Utter Ave Staten Island NY 10314 | |
| (708) 630-1534 | |
| Not Available |
| Full Name | Carend Provider Group Of Ny |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 191 Utter Ave, Staten Island, New York |
| Authorized Official Name and Position | Awss Zidan (PRESIDENT) |
| Authorized Official Contact | 7086301534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carend Provider Group Of Ny 2045 W. Grand Ave Ste B Pmb 89496 Chicago IL 60612 Ph: (708) 630-1534 | Carend Provider Group Of Ny 191 Utter Ave Staten Island NY 10314 Ph: (708) 630-1534 |
| NPI Number | 1295417632 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 7618329475 |
|---|---|
| Medicare Enrollment ID | O20240117001292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295417632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Awss Zidan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225472525 PECOS PAC ID: 2567730807 Enrollment ID: I20220912000977 |
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