Complete Care Medical Of N.y. P.c. | |
311 Saint Nicholas Ave Ste E Ridgewood NY 11385-2296 | |
(718) 894-2500 | |
(718) 417-4535 |
Full Name | Complete Care Medical Of N.y. P.c. |
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Speciality | Internal Medicine |
Location | 311 Saint Nicholas Ave Ste E, Ridgewood, New York |
Authorized Official Name and Position | Mariano Mederos (M.D.) |
Authorized Official Contact | 7188942500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Complete Care Medical Of N.y. P.c. 311 Saint Nicholas Ave Ste E Ridgewood NY 11385-2296 Ph: (718) 894-2500 | Complete Care Medical Of N.y. P.c. 311 Saint Nicholas Ave Ste E Ridgewood NY 11385-2296 Ph: (718) 894-2500 |
NPI Number | 1346542818 |
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Provider Enumeration Date | 12/03/2010 |
Last Update Date | 06/06/2016 |
Medicare PECOS PAC ID | 6709043896 |
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Medicare Enrollment ID | O20120201000198 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346542818 | NPI | - | NPPES |
00947791 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Mariano Mederos |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598743007 PECOS PAC ID: 8224295316 Enrollment ID: I20120201000236 |
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