| Queens Multicare Psychiatric Services, Pc | |
|
20922 Hillside Ave Queens Village NY 11427-1715 | |
| (718) 217-6279 | |
| (718) 217-6279 |
| Full Name | Queens Multicare Psychiatric Services, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20922 Hillside Ave, Queens Village, New York |
| Authorized Official Name and Position | Joseph Roosevelt Clerisme (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7182176279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Multicare Psychiatric Services, Pc 20922 Hillside Ave Queens Village NY 11427-1715 Ph: (718) 217-6279 | Queens Multicare Psychiatric Services, Pc 20922 Hillside Ave Queens Village NY 11427-1715 Ph: (718) 217-6279 |
| NPI Number | 1588971782 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 8123281995 |
|---|---|
| Medicare Enrollment ID | O20120516000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588971782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 154315 (New York) | Primary |
| Provider Name | Joseph R Clerisme |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790721710 PECOS PAC ID: 7416933445 Enrollment ID: I20040629000611 |
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