| Ohio | |
|
9704 Sutphin Blvd Jamaica NY 11435-4721 | |
| (718) 657-7088 | |
| (718) 657-7092 |
| Full Name | Ohio |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 9704 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Alan J. Wengrofsky (VICE PRESIDENT OF FINANCE AND CFO) |
| Authorized Official Contact | 2125452481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohio 60 Madison Ave 5th Floor New York NY 10010-1600 Ph: (212) 545-2439 | Ohio 9704 Sutphin Blvd Jamaica NY 11435-4721 Ph: (718) 657-7088 |
| NPI Number | 1508222522 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 05/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508222522 | NPI | - | NPPES |
| 000695941 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7002119R (New York) | Primary |
Empire Gate Medical P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8810 Parsons Blvd, Jamaica, NY 11432 Phone: 718-291-8111 Fax: 718-487-9343 | |
Citadel Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9023 161st St, Jamaica, NY 11432 Phone: 718-709-5054 Fax: 212-366-1773 | |
Optometry Mobile Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9704 Sutphin Blvd, Jamaica, NY 11435 Phone: 718-657-7088 Fax: 718-657-7092 | |
Exedus Family Healthcare & Wellness Care Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11410 Merrick Blvd, Jamaica, NY 11434 Phone: 718-233-2972 Fax: 667-771-0892 | |
South Merrick Np In Adult Health P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10825 Merrick Blvd, Jamaica, NY 11433 Phone: 718-658-9700 | |
Physician Medical Services, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8216 164th Pl, 1st Floor, Jamaica, NY 11432 Phone: 646-644-8067 | |
Bright Eyes Vision Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12221a Guy R Brewer Blvd, Jamaica, NY 11434 Phone: 718-527-0550 Fax: 718-527-0546 |