| Mekala Ramgopal Pc | |
|
2124 Camp Rd Far Rockaway NY 11691-2721 | |
| (516) 431-2656 | |
| (516) 432-8484 |
| Full Name | Mekala Ramgopal Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2124 Camp Rd, Far Rockaway, New York |
| Authorized Official Name and Position | Mekala Ramgopal (PRESIDENT) |
| Authorized Official Contact | 5164312656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mekala Ramgopal Pc 82 Regent Dr Lido Beach NY 11561-4923 Ph: (516) 431-2656 | Mekala Ramgopal Pc 2124 Camp Rd Far Rockaway NY 11691-2721 Ph: (516) 431-2656 |
| NPI Number | 1730307000 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 10/29/2008 |
| Medicare PECOS PAC ID | 6709775240 |
|---|---|
| Medicare Enrollment ID | O20081103000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730307000 | NPI | - | NPPES |
| 00394069 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 138691 (New York) | Primary |
| Provider Name | Mekala Ramgopal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336210178 PECOS PAC ID: 5395804512 Enrollment ID: I20081103000574 |
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