| Jib Medical P.c. | |
|
15811 Harry Van Arsdale Jr Ave 2nd Floor Flushing NY 11365-3085 | |
| (718) 591-2400 | |
| (718) 591-9528 |
| Full Name | Jib Medical P.c. |
|---|---|
| Speciality | General Practice |
| Location | 15811 Harry Van Arsdale Jr Ave, Flushing, New York |
| Authorized Official Name and Position | Michael E Makover (CEO, CMO) |
| Authorized Official Contact | 7185912000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jib Medical P.c. 15811 Harry Van Arsdale Jr Ave 2nd Floor Flushing NY 11365-3085 Ph: (718) 591-2400 | Jib Medical P.c. 15811 Harry Van Arsdale Jr Ave 2nd Floor Flushing NY 11365-3085 Ph: (718) 591-2400 |
| NPI Number | 1215334321 |
|---|---|
| Provider Enumeration Date | 12/04/2014 |
| Last Update Date | 02/11/2015 |
| Medicare PECOS PAC ID | 7810201886 |
|---|---|
| Medicare Enrollment ID | O20150804005253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215334321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeffrey M Freilich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902833189 PECOS PAC ID: 6709836380 Enrollment ID: I20050201000255 |
| Provider Name | Elizabeth A Odierna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447349766 PECOS PAC ID: 0941256994 Enrollment ID: I20050323000769 |
| Provider Name | Sharon A Foster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649213745 PECOS PAC ID: 0749299675 Enrollment ID: I20060420000281 |
| Provider Name | Frank Noto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134232176 PECOS PAC ID: 5193720233 Enrollment ID: I20060925000425 |
| Provider Name | Meera Prabhat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144212036 PECOS PAC ID: 7618078601 Enrollment ID: I20070720000262 |
| Provider Name | Paul A.c. Greenberg |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1427057975 PECOS PAC ID: 5597950188 Enrollment ID: I20101109000564 |
| Provider Name | Regina Sydor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144579376 PECOS PAC ID: 7113170333 Enrollment ID: I20130118000400 |
| Provider Name | Chenguang T Tao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720304066 PECOS PAC ID: 6002040102 Enrollment ID: I20131003000081 |
| Provider Name | Jennifer A Halstead |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184683641 PECOS PAC ID: 9335466382 Enrollment ID: I20150331002628 |
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