| Dutch Broadway Family Medical Care, P.c. | |
|
2366 Dutch Broadway Elmont NY 11003-3508 | |
| (516) 488-8599 | |
| Not Available |
| Full Name | Dutch Broadway Family Medical Care, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2366 Dutch Broadway, Elmont, New York |
| Authorized Official Name and Position | Max Noel (OWNER) |
| Authorized Official Contact | 5164888595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dutch Broadway Family Medical Care, P.c. 2366 Dutch Broadway Elmont NY 11003-3508 Ph: (516) 488-8599 | Dutch Broadway Family Medical Care, P.c. 2366 Dutch Broadway Elmont NY 11003-3508 Ph: (516) 488-8599 |
| NPI Number | 1013022987 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 09/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013022987 | NPI | - | NPPES |
| 02624091 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 230045 (New York) | Primary |
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