| J-cap | |
|
116-30 Sutphin Blvd. Jamaica NY 11434-1527 | |
| (718) 322-2500 | |
| (718) 322-1881 |
| Full Name | J-cap |
|---|---|
| Speciality | Clinic/Center |
| Location | 116-30 Sutphin Blvd., Jamaica, New York |
| Authorized Official Name and Position | Vicky Gatell (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7189607629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J-cap 311 E 175th St Bronx NY 10457-5859 Ph: (718) 960-7568 | J-cap 116-30 Sutphin Blvd. Jamaica NY 11434-1527 Ph: (718) 322-2500 |
| NPI Number | 1679641757 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 09/23/2022 |
| Medicare PECOS PAC ID | 0749407237 |
|---|---|
| Medicare Enrollment ID | O20140806002052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679641757 | NPI | - | NPPES |
| 01090000 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 090310090 (New York) | Secondary |
| Provider Name | Yulan Nash-daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457618274 PECOS PAC ID: 2668809807 Enrollment ID: I20200227001263 |
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