Medpro | |
6527 Roosevelt Ave # 1a Woodside NY 11377-2927 | |
(718) 550-2273 | |
(718) 550-2274 |
Full Name | Medpro |
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Speciality | Clinic/Center |
Location | 6527 Roosevelt Ave # 1a, Woodside, New York |
Authorized Official Name and Position | Shahida Khan (CEO) |
Authorized Official Contact | 7185502273 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Medpro 6527 Roosevelt Ave # 1a Woodside NY 11377-2927 Ph: (718) 550-2273 | Medpro 6527 Roosevelt Ave # 1a Woodside NY 11377-2927 Ph: (718) 550-2273 |
NPI Number | 1124781398 |
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Provider Enumeration Date | 10/14/2021 |
Last Update Date | 10/25/2024 |
Medicare PECOS PAC ID | 4385036045 |
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Medicare Enrollment ID | O20220110001852 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124781398 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Shahida A Khan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245338300 PECOS PAC ID: 7719973114 Enrollment ID: I20040421001668 |
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