| 4016 Elmhurst Medical Pc | |
|
4016 74th St Elmhurst NY 11373-5602 | |
| (718) 682-7090 | |
| Not Available |
| Full Name | 4016 Elmhurst Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4016 74th St, Elmhurst, New York |
| Authorized Official Name and Position | Choudhury Hasan (MD) |
| Authorized Official Contact | 9173368422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4016 Elmhurst Medical Pc 4016 74th St Elmhurst NY 11373-5602 Ph: () - | 4016 Elmhurst Medical Pc 4016 74th St Elmhurst NY 11373-5602 Ph: (718) 682-7090 |
| NPI Number | 1497326607 |
|---|---|
| Provider Enumeration Date | 07/08/2021 |
| Last Update Date | 12/09/2022 |
| Medicare PECOS PAC ID | 1254739121 |
|---|---|
| Medicare Enrollment ID | O20211006002557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497326607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Choudhury M Hasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669850210 PECOS PAC ID: 5991042418 Enrollment ID: I20190122003021 |
| Provider Name | Saniya Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669759684 PECOS PAC ID: 0042629453 Enrollment ID: I20210513002801 |
| Provider Name | Shalena Islam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386120095 PECOS PAC ID: 2668875055 Enrollment ID: I20210722002159 |
| Provider Name | Leelamma Samuel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205122512 PECOS PAC ID: 6608243217 Enrollment ID: I20221110000162 |
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