Domenick Acquista, Md, Pc | |
3101 Vernon Blvd Long Island City NY 11106-4870 | |
(718) 362-1321 | |
Not Available |
Full Name | Domenick Acquista, Md, Pc |
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Speciality | Internal Medicine |
Location | 3101 Vernon Blvd, Long Island City, New York |
Authorized Official Name and Position | Domenick Acquista (PRESIDENT) |
Authorized Official Contact | 7183621321 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Domenick Acquista, Md, Pc 3101 Vernon Blvd Long Island City NY 11106-4870 Ph: (718) 362-1321 | Domenick Acquista, Md, Pc 3101 Vernon Blvd Long Island City NY 11106-4870 Ph: (718) 362-1321 |
NPI Number | 1134830110 |
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Provider Enumeration Date | 12/09/2022 |
Last Update Date | 12/09/2022 |
Medicare PECOS PAC ID | 0244602852 |
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Medicare Enrollment ID | O20230208001278 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134830110 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Domenick A Acquista |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225270879 PECOS PAC ID: 1355507898 Enrollment ID: I20120727000022 |
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