| Juan A Medina Medical Office Pc | |
|
870 Central Ave Far Rockaway NY 11691-4660 | |
| (718) 327-3458 | |
| (718) 337-2390 |
| Full Name | Juan A Medina Medical Office Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 870 Central Ave, Far Rockaway, New York |
| Authorized Official Name and Position | Juan Antonio Medina (PRESIDENT) |
| Authorized Official Contact | 7183273458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan A Medina Medical Office Pc 870 Central Ave Far Rockaway NY 11691-4660 Ph: (718) 327-3458 | Juan A Medina Medical Office Pc 870 Central Ave Far Rockaway NY 11691-4660 Ph: (718) 327-3458 |
| NPI Number | 1477868032 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 08/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477868032 | NPI | - | NPPES |
| 02989077 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 245701 (New York) | Primary |
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