Active Care Physician Pc | |
70 Bowery Suite 404 New York NY 10013-4607 | |
(212) 343-8290 | |
(212) 343-8328 |
Full Name | Active Care Physician Pc |
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Speciality | Internal Medicine |
Location | 70 Bowery, New York, New York |
Authorized Official Name and Position | Blanche Sau Leung (PRESIDENT) |
Authorized Official Contact | 2123438290 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Active Care Physician Pc 70 Bowery Suite 404 New York NY 10013-4607 Ph: (212) 343-8290 | Active Care Physician Pc 70 Bowery Suite 404 New York NY 10013-4607 Ph: (212) 343-8290 |
NPI Number | 1912244567 |
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Provider Enumeration Date | 01/15/2013 |
Last Update Date | 01/15/2013 |
Medicare PECOS PAC ID | 8921244716 |
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Medicare Enrollment ID | O20130424000261 |
Identifier | Type | State | Issuer |
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1912244567 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 213122 (New York) | Primary |
Provider Name | Blanche S Leung |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124082011 PECOS PAC ID: 4082629837 Enrollment ID: I20060215000241 |
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