| Meera S. Boppana,md.pc | |
|
10415 101st Ave Ozone Park NY 11416-2702 | |
| (718) 441-0660 | |
| (718) 847-1538 |
| Full Name | Meera S. Boppana,md.pc |
|---|---|
| Speciality | Family Medicine |
| Location | 10415 101st Ave, Ozone Park, New York |
| Authorized Official Name and Position | Meera S Boppana (PRESIDENT) |
| Authorized Official Contact | 7184410660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meera S. Boppana,md.pc 150-38 Union Turnpike #12e Flushing NY 11367-2702 Ph: (718) 441-0660 | Meera S. Boppana,md.pc 10415 101st Ave Ozone Park NY 11416-2702 Ph: (718) 441-0660 |
| NPI Number | 1679745533 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 7214980531 |
|---|---|
| Medicare Enrollment ID | O20050228000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679745533 | NPI | - | NPPES |
| 01305908 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 175209 (New York) | Primary |
| Provider Name | Meera S Boppana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023088325 PECOS PAC ID: 2163618851 Enrollment ID: I20101119000838 |
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