| October Medical Pc | |
|
3704 91st St Ste D Jackson Heights NY 11372-7909 | |
| (929) 401-4936 | |
| (516) 534-4666 |
| Full Name | October Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3704 91st St Ste D, Jackson Heights, New York |
| Authorized Official Name and Position | Sonia Evadne Walker-adamson (DO) |
| Authorized Official Contact | 5164046550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| October Medical Pc 3704 91st St Ste D Jackson Heights NY 11372-7909 Ph: (929) 401-4936 | October Medical Pc 3704 91st St Ste D Jackson Heights NY 11372-7909 Ph: (929) 401-4936 |
| NPI Number | 1639868763 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 01/11/2024 |
| Medicare PECOS PAC ID | 0941666473 |
|---|---|
| Medicare Enrollment ID | O20230525001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639868763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sonia E Walker-adamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184789778 PECOS PAC ID: 9830277847 Enrollment ID: I20080416000294 |
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