| Days Nurse Practitioner In Family Health P.c. | |
|
14210 Roosevelt Ave Ste P10 Flushing NY 11354-6000 | |
| (929) 362-2082 | |
| (929) 362-2083 |
| Full Name | Days Nurse Practitioner In Family Health P.c. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 14210 Roosevelt Ave Ste P10, Flushing, New York |
| Authorized Official Name and Position | Shengjie Mo (FAMILY PHYSICIAN) |
| Authorized Official Contact | 9178810690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Days Nurse Practitioner In Family Health P.c. 15751 19th Ave Whitestone NY 11357-3820 Ph: (917) 881-0690 | Days Nurse Practitioner In Family Health P.c. 14210 Roosevelt Ave Ste P10 Flushing NY 11354-6000 Ph: (929) 362-2082 |
| NPI Number | 1114668969 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 06/17/2022 |
| Medicare PECOS PAC ID | 1951780196 |
|---|---|
| Medicare Enrollment ID | O20220620000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114668969 | NPI | - | NPPES |
| 02265465 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Shengjie Mo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770601015 PECOS PAC ID: 2860871001 Enrollment ID: I20220620000276 |
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