| Jennan Comprehensive Medical Pc | |
|
762 59th St Brooklyn NY 11220-3936 | |
| (718) 567-8899 | |
| (718) 765-0383 |
| Full Name | Jennan Comprehensive Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 762 59th St, Brooklyn, New York |
| Authorized Official Name and Position | Katherine Ma (ADMINISTRATOR) |
| Authorized Official Contact | 7185678899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennan Comprehensive Medical Pc 762 59th St Brooklyn NY 11220-3936 Ph: (718) 567-8899 | Jennan Comprehensive Medical Pc 762 59th St Brooklyn NY 11220-3936 Ph: (718) 567-8899 |
| NPI Number | 1831284512 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 09/29/2009 |
| Medicare PECOS PAC ID | 7810951530 |
|---|---|
| Medicare Enrollment ID | O20041112000811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831284512 | NPI | - | NPPES |
| 02867976 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New York) | Primary |
| Provider Name | Qing Xiang Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891812806 PECOS PAC ID: 2961485198 Enrollment ID: I20040609001099 |
| Provider Name | Yanhan David Huang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780654558 PECOS PAC ID: 7911915764 Enrollment ID: I20060405000268 |
| Provider Name | Henry S Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093793101 PECOS PAC ID: 5698739316 Enrollment ID: I20070502000438 |
| Provider Name | Tina Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497847578 PECOS PAC ID: 4688764384 Enrollment ID: I20071219000063 |
| Provider Name | John Yiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740440155 PECOS PAC ID: 0941474795 Enrollment ID: I20111114000475 |
| Provider Name | Riza Lina S Alao |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184646168 PECOS PAC ID: 5799936811 Enrollment ID: I20130611000008 |
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