| Ozone Park Quality Care Medicine Pllc | |
|
7721 101st Ave Fl 1 Ozone Park NY 11416 | |
| (718) 322-4014 | |
| (718) 322-4015 |
| Full Name | Ozone Park Quality Care Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7721 101st Ave Fl 1, Ozone Park, New York |
| Authorized Official Name and Position | Musammat Rounak Jahan (OWNER) |
| Authorized Official Contact | 7183224014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozone Park Quality Care Medicine Pllc 1 Jara Ct New Hyde Park NY 11040-3117 Ph: (718) 322-4014 | Ozone Park Quality Care Medicine Pllc 7721 101st Ave Fl 1 Ozone Park NY 11416 Ph: (718) 322-4014 |
| NPI Number | 1205336591 |
|---|---|
| Provider Enumeration Date | 02/14/2018 |
| Last Update Date | 09/05/2018 |
| Medicare PECOS PAC ID | 6507111796 |
|---|---|
| Medicare Enrollment ID | O20180612000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205336591 | NPI | - | NPPES |
| 1699188680 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 285335 (New York) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Musammat Rounak Jahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699188680 PECOS PAC ID: 6406142538 Enrollment ID: I20160915001365 |
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