| Junction Medical Office, P.c. | |
|
9211 35th Ave Suite 1e Jackson Heights NY 11372-5866 | |
| (718) 429-4555 | |
| (718) 429-4556 |
| Full Name | Junction Medical Office, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 9211 35th Ave, Jackson Heights, New York |
| Authorized Official Name and Position | Fausto Abraham Gonzalez (PHYSICIAN) |
| Authorized Official Contact | 7184294555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Junction Medical Office, P.c. 9211 35th Ave Suite 1e Jackson Heights NY 11372-5866 Ph: (718) 429-4555 | Junction Medical Office, P.c. 9211 35th Ave Suite 1e Jackson Heights NY 11372-5866 Ph: (718) 429-4555 |
| NPI Number | 1538306352 |
|---|---|
| Provider Enumeration Date | 01/15/2009 |
| Last Update Date | 09/04/2009 |
| Medicare PECOS PAC ID | 0648328906 |
|---|---|
| Medicare Enrollment ID | O20090427000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538306352 | NPI | - | NPPES |
| 03131142 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 229968 (New York) | Primary |
| Provider Name | Fausto Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124087713 PECOS PAC ID: 4082607957 Enrollment ID: I20040514001006 |
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