| Charles B. Wang Community Health Center, Inc. | |
|
13743 45th Ave Flushing NY 11355-4048 | |
| (929) 362-3018 | |
| (929) 362-3023 |
| Full Name | Charles B. Wang Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 13743 45th Ave, Flushing, New York |
| Authorized Official Name and Position | Kaushal Challa (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2123796988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles B. Wang Community Health Center, Inc. 268 Canal St New York NY 10013-3599 Ph: (212) 379-6988 | Charles B. Wang Community Health Center, Inc. 13743 45th Ave Flushing NY 11355-4048 Ph: (929) 362-3018 |
| NPI Number | 1407229651 |
|---|---|
| Provider Enumeration Date | 11/10/2015 |
| Last Update Date | 11/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407229651 | NPI | - | NPPES |
| 00356318 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7002107R (New York) | Primary |
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