| Intercity Gastroenterology P.c | |
|
19303 Union Tpke Fresh Meadows NY 11366-1874 | |
| (516) 721-4648 | |
| Not Available |
| Full Name | Intercity Gastroenterology P.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 19303 Union Tpke, Fresh Meadows, New York |
| Authorized Official Name and Position | Ghulamullah Shahzad (PRESIDENT) |
| Authorized Official Contact | 5167848331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercity Gastroenterology P.c 957 N 1st St New Hyde Park NY 11040-2821 Ph: (516) 784-8331 | Intercity Gastroenterology P.c 19303 Union Tpke Fresh Meadows NY 11366-1874 Ph: (516) 721-4648 |
| NPI Number | 1346779501 |
|---|---|
| Provider Enumeration Date | 06/09/2017 |
| Last Update Date | 08/31/2022 |
| Medicare PECOS PAC ID | 4284049511 |
|---|---|
| Medicare Enrollment ID | O20210614000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346779501 | NPI | - | NPPES |
| 03190443 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 252160 (New York) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Arif Hameed |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1952390866 PECOS PAC ID: 6901996693 Enrollment ID: I20071219000002 |
| Provider Name | Ghulamullah Shahzad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710128996 PECOS PAC ID: 8224164769 Enrollment ID: I20100412000051 |
| Provider Name | Fangming Deng |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205072352 PECOS PAC ID: 4082885876 Enrollment ID: I20110928000307 |
| Provider Name | Sumbal Augustine Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669169256 PECOS PAC ID: 2062862782 Enrollment ID: I20231221000977 |
Rajesh Kalra M.d P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 178-11 Union Turnpike, Fresh Meadows, NY 11366 Phone: 516-729-7282 | |
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Frank Evanov Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19303 Union Tpke, Fresh Meadows, NY 11366 Phone: 718-217-8400 | |
Nyhq-center For Developmental Disabilities Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5916 174th St, Fresh Meadows, NY 11365 Phone: 718-670-2731 Fax: 516-437-4167 | |
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