| Millennium Medical Group Pc | |
|
93-20a Roosevelt Ave. 2nd Floor Jackson Heights NY 11372-7904 | |
| (718) 404-9157 | |
| (718) 424-0414 |
| Full Name | Millennium Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 93-20a Roosevelt Ave., Jackson Heights, New York |
| Authorized Official Name and Position | Jose A Fulgencio-delmonte (MD) |
| Authorized Official Contact | 7184049157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Medical Group Pc 93-20a Roosevelt Ave. 2nd Floor Jackson Heights NY 11372-7904 Ph: (718) 404-9157 | Millennium Medical Group Pc 93-20a Roosevelt Ave. 2nd Floor Jackson Heights NY 11372-7904 Ph: (718) 404-9157 |
| NPI Number | 1386725695 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 5890695134 |
|---|---|
| Medicare Enrollment ID | O20040112000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386725695 | NPI | - | NPPES |
| 01664373 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 203635 (New York) | Primary |
| Provider Name | Jose A Fulgencio-delmonte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134109382 PECOS PAC ID: 9638065022 Enrollment ID: I20040224000083 |
| Provider Name | Richard L Francisco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902868227 PECOS PAC ID: 1557261708 Enrollment ID: I20060111001237 |
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