| Crescent Medical Pc | |
|
10825 Merrick Blvd Jamaica NY 11433-2906 | |
| (718) 658-9700 | |
| (718) 658-9703 |
| Full Name | Crescent Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 10825 Merrick Blvd, Jamaica, New York |
| Authorized Official Name and Position | Samuel Roy Walters (OWNER) |
| Authorized Official Contact | 7186589700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Medical Pc 10825 Merrick Blvd Jamaica NY 11433-2906 Ph: (718) 658-9700 | Crescent Medical Pc 10825 Merrick Blvd Jamaica NY 11433-2906 Ph: (718) 658-9700 |
| NPI Number | 1063866838 |
|---|---|
| Provider Enumeration Date | 04/19/2016 |
| Last Update Date | 04/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063866838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 115662 (New York) | Primary |
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