| Long Beach Family Medicine Pc | |
|
10 Franklin Blvd Apt 102 Long Beach NY 11561-4511 | |
| (516) 889-0100 | |
| Not Available |
| Full Name | Long Beach Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 10 Franklin Blvd Apt 102, Long Beach, New York |
| Authorized Official Name and Position | Sergey Kulikov (PRES.) |
| Authorized Official Contact | 5168890100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Beach Family Medicine Pc 10 Franklin Blvd Apt 102 Long Beach NY 11561-4511 Ph: (516) 889-0100 | Long Beach Family Medicine Pc 10 Franklin Blvd Apt 102 Long Beach NY 11561-4511 Ph: (516) 889-0100 |
| NPI Number | 1629299516 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 09/25/2015 |
| Medicare PECOS PAC ID | 0244336113 |
|---|---|
| Medicare Enrollment ID | O20070509000687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629299516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Sergey Kulikov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821177825 PECOS PAC ID: 3779563887 Enrollment ID: I20040721000155 |
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