| Mmj Ny Consulting Llc | |
|
13630 Maple Ave Ste 2b Flushing NY 11355-3867 | |
| (718) 799-0958 | |
| (718) 799-0959 |
| Full Name | Mmj Ny Consulting Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13630 Maple Ave Ste 2b, Flushing, New York |
| Authorized Official Name and Position | Linke Ma (PHYSICIAN) |
| Authorized Official Contact | 3474172563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmj Ny Consulting Llc 13630 Maple Ave Ste 2b Flushing NY 11355-3867 Ph: (718) 799-0958 | Mmj Ny Consulting Llc 13630 Maple Ave Ste 2b Flushing NY 11355-3867 Ph: (718) 799-0958 |
| NPI Number | 1184331308 |
|---|---|
| Provider Enumeration Date | 10/28/2022 |
| Last Update Date | 10/28/2022 |
| Medicare PECOS PAC ID | 0840664579 |
|---|---|
| Medicare Enrollment ID | O20230321001493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184331308 | NPI | - | NPPES |
| 1932553427 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Linke Ma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932553427 PECOS PAC ID: 5294079828 Enrollment ID: I20190828001874 |
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