| Excel Medical Pc | |
|
4348 Colden Street Flushing NY 11355 | |
| (718) 961-5060 | |
| (718) 961-5900 |
| Full Name | Excel Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4348 Colden Street, Flushing, New York |
| Authorized Official Name and Position | Mikhail B Pinkhasov (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7189615060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Medical Pc Po Box 520390 Flushing NY 11352-0390 Ph: (718) 755-0656 | Excel Medical Pc 4348 Colden Street Flushing NY 11355 Ph: (718) 961-5060 |
| NPI Number | 1003005083 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 04/10/2008 |
| Medicare PECOS PAC ID | 4486741303 |
|---|---|
| Medicare Enrollment ID | O20071024000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003005083 | NPI | - | NPPES |
| 02889710 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 244694 (New York) | Primary |
| Provider Name | Mikhail B Pinkhasov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427255439 PECOS PAC ID: 2961503941 Enrollment ID: I20070720000162 |
| Provider Name | Lev Yakubov |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821032491 PECOS PAC ID: 3173699873 Enrollment ID: I20080903000565 |
| Provider Name | Rosita Cadalin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912354051 PECOS PAC ID: 9436432176 Enrollment ID: I20170203001187 |
| Provider Name | Ian A Sherman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639682990 PECOS PAC ID: 1254678238 Enrollment ID: I20190129002678 |
| Provider Name | Ngozi Onuachu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174901078 PECOS PAC ID: 4981946670 Enrollment ID: I20190429002611 |
| Provider Name | Ju Hye Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093371486 PECOS PAC ID: 0749514529 Enrollment ID: I20190627002423 |
| Provider Name | Ndidi Okuesi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346565025 PECOS PAC ID: 9436488277 Enrollment ID: I20190904002238 |
| Provider Name | Hyerim Jeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699326009 PECOS PAC ID: 5890122790 Enrollment ID: I20200304002314 |
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