| Ny Family Medicine Pc | |
|
14809 Northern Blvd Ste 1k Flushing NY 11354-4308 | |
| (347) 506-0325 | |
| (347) 506-0314 |
| Full Name | Ny Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 14809 Northern Blvd Ste 1k, Flushing, New York |
| Authorized Official Name and Position | Daniel Doyoung Park (OWNER) |
| Authorized Official Contact | 3475060325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ny Family Medicine Pc 14809 Northern Blvd Ste 1k Flushing NY 11354-4308 Ph: (347) 506-0325 | Ny Family Medicine Pc 14809 Northern Blvd Ste 1k Flushing NY 11354-4308 Ph: (347) 506-0325 |
| NPI Number | 1205563319 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 5294111886 |
|---|---|
| Medicare Enrollment ID | O20221005001828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205563319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel D Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831239391 PECOS PAC ID: 3173781374 Enrollment ID: I20120220000413 |
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