| Echenique Medical Office Pc | |
|
41-15 162nd Street Flushing NY 11358-4124 | |
| (718) 762-6640 | |
| (718) 762-6635 |
| Full Name | Echenique Medical Office Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 41-15 162nd Street, Flushing, New York |
| Authorized Official Name and Position | Evelio Echenique (PRESIDENT) |
| Authorized Official Contact | 7187626640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Echenique Medical Office Pc 41-15 162nd Street Flushing NY 11358-4124 Ph: (718) 762-6640 | Echenique Medical Office Pc 41-15 162nd Street Flushing NY 11358-4124 Ph: (718) 762-6640 |
| NPI Number | 1942532791 |
|---|---|
| Provider Enumeration Date | 02/04/2010 |
| Last Update Date | 04/18/2012 |
| Medicare PECOS PAC ID | 7113053802 |
|---|---|
| Medicare Enrollment ID | O20100406000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942532791 | NPI | - | NPPES |
| 05095 | Other | NY | MEDICARE ID# |
| 02457472 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 212182 (New York) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | John T Rigney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255449229 PECOS PAC ID: 6103814272 Enrollment ID: I20040505001559 |
| Provider Name | Evelio Echenique |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700839578 PECOS PAC ID: 3779554993 Enrollment ID: I20040803000158 |
| Provider Name | Galina Stolina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174529622 PECOS PAC ID: 1951438498 Enrollment ID: I20100415000092 |
| Provider Name | Sudhir Gadh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245458835 PECOS PAC ID: 6800184276 Enrollment ID: I20161018001794 |
| Provider Name | Abidemi Akinkunmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588991210 PECOS PAC ID: 9537431531 Enrollment ID: I20170825003155 |
| Provider Name | Marlen E Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629543038 PECOS PAC ID: 1355688524 Enrollment ID: I20190125000641 |
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