| Arbor Medical Pc | |
|
6 Presley St Staten Island NY 10308-3239 | |
| (718) 984-0969 | |
| (718) 984-4097 |
| Full Name | Arbor Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6 Presley St, Staten Island, New York |
| Authorized Official Name and Position | Lisa Rose Hernandez (DIRECTOR) |
| Authorized Official Contact | 7189840969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arbor Medical Pc 6 Presley St Staten Island NY 10308-3239 Ph: (718) 984-0969 | Arbor Medical Pc 6 Presley St Staten Island NY 10308-3239 Ph: (718) 984-0969 |
| NPI Number | 1174650444 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 12/20/2012 |
| Medicare PECOS PAC ID | 5395642904 |
|---|---|
| Medicare Enrollment ID | O20031212000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174650444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 166698 (New York) | Primary |
| Provider Name | Lisa R Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043278047 PECOS PAC ID: 6901702570 Enrollment ID: I20031212000420 |
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