Good Medical Care, Pllc | |
351 Onderdonk Ave Ridgewood NY 11385-1334 | |
(718) 418-3335 | |
(718) 418-6584 |
Full Name | Good Medical Care, Pllc |
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Speciality | Family Medicine |
Location | 351 Onderdonk Ave, Ridgewood, New York |
Authorized Official Name and Position | Augusto A Zevallos (MEDICAL DOCTOR) |
Authorized Official Contact | 7184183335 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Good Medical Care, Pllc 672 Dogwood Ave Franklin Square NY 11010-3247 Ph: (718) 418-3335 | Good Medical Care, Pllc 351 Onderdonk Ave Ridgewood NY 11385-1334 Ph: (718) 418-3335 |
NPI Number | 1114477817 |
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Provider Enumeration Date | 10/06/2016 |
Last Update Date | 10/06/2016 |
Medicare PECOS PAC ID | 9436439866 |
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Medicare Enrollment ID | O20161201000369 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114477817 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | 214540 (New York) | Primary |
Provider Name | Augusto Zevallos |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962547331 PECOS PAC ID: 4183710536 Enrollment ID: I20071016000150 |
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