| Latina Medica, Pc | |
|
10119 39th Ave Suite # 101 Corona NY 11368-4806 | |
| (347) 808-8325 | |
| (347) 808-8326 |
| Full Name | Latina Medica, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10119 39th Ave, Corona, New York |
| Authorized Official Name and Position | Kim Moi Wong Lama (PRESIDENT) |
| Authorized Official Contact | 3478088325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Latina Medica, Pc 10119 39th Ave Suite # 101 Corona NY 11368-4806 Ph: (347) 808-8325 | Latina Medica, Pc 10119 39th Ave Suite # 101 Corona NY 11368-4806 Ph: (347) 808-8325 |
| NPI Number | 1376813782 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 06/11/2012 |
| Medicare PECOS PAC ID | 4688800832 |
|---|---|
| Medicare Enrollment ID | O20131119000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376813782 | NPI | - | NPPES |
| 258195 | Other | NY | NYS LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 258195 (New York) | Primary |
| Provider Name | Peter E Zambito |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497978456 PECOS PAC ID: 8325231897 Enrollment ID: I20101018000608 |
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