| Parkway Preventive Medical Care Pllc | |
|
1711 Brookhaven Ave Far Rockaway NY 11691-4406 | |
| (718) 534-0689 | |
| Not Available |
| Full Name | Parkway Preventive Medical Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1711 Brookhaven Ave, Far Rockaway, New York |
| Authorized Official Name and Position | Perry Stein (OWNER) |
| Authorized Official Contact | 7185340689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkway Preventive Medical Care Pllc 383 Ocean Pkwy Brooklyn NY 11218-4756 Ph: () - | Parkway Preventive Medical Care Pllc 1711 Brookhaven Ave Far Rockaway NY 11691-4406 Ph: (718) 534-0689 |
| NPI Number | 1578318143 |
|---|---|
| Provider Enumeration Date | 04/18/2024 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 8820536428 |
|---|---|
| Medicare Enrollment ID | O20240814001543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578318143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Wanda Evelyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912097015 PECOS PAC ID: 0042254609 Enrollment ID: I20050614001144 |
| Provider Name | Natalie Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922282029 PECOS PAC ID: 8426303033 Enrollment ID: I20180622001978 |
| Provider Name | Muhammad Rajib Hossain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679962732 PECOS PAC ID: 8628330495 Enrollment ID: I20201001002598 |
| Provider Name | Mahidul Chowduary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962063255 PECOS PAC ID: 1052797891 Enrollment ID: I20221003001754 |
| Provider Name | Baikuntha Chaulagai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093201816 PECOS PAC ID: 1557615366 Enrollment ID: I20240201003743 |
| Provider Name | Brucha Wanounou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962230607 PECOS PAC ID: 8426596024 Enrollment ID: I20240814001733 |
| Provider Name | Africa Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841999562 PECOS PAC ID: 2769822766 Enrollment ID: I20240826002581 |
| Provider Name | Jane Renelle Bisa-cister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861843161 PECOS PAC ID: 4880134568 Enrollment ID: I20240909002680 |
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