| Glendale Family Medicine,pc | |
|
7801 Myrtle Ave Glendale NY 11385-7439 | |
| (718) 386-8300 | |
| (718) 386-0437 |
| Full Name | Glendale Family Medicine,pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7801 Myrtle Ave, Glendale, New York |
| Authorized Official Name and Position | Wayne Sebastiano (OWNER) |
| Authorized Official Contact | 7183868300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Family Medicine,pc 7801 Myrtle Ave Glendale NY 11385-7439 Ph: (718) 386-8300 | Glendale Family Medicine,pc 7801 Myrtle Ave Glendale NY 11385-7439 Ph: (718) 386-8300 |
| NPI Number | 1346444734 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 11/25/2015 |
| Medicare PECOS PAC ID | 0749206563 |
|---|---|
| Medicare Enrollment ID | O20051020001068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346444734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 168147 (New York) | Primary |
| Provider Name | Wayne R Sebastiano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841238722 PECOS PAC ID: 6002832821 Enrollment ID: I20110407000485 |
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