| |
7901 Broadway, Room A1-19, Elmhurst, NY 11373-1329 | |
(718) 334-4952 | |
(718) 334-4815 |
Full Name | |
---|---|
Type | Facility |
Speciality | Surgery |
Location | 7901 Broadway, Elmhurst, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942430244 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
208600000X | Surgery | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
7901 Broadway, Room A1-19, Elmhurst, NY 11373-1329 Ph: (718) 334-4952 | 7901 Broadway, Room A1-19, Elmhurst, NY 11373-1329 Ph: (718) 334-4952 |