| Pederson Krag | |
|
142-02 20th Avenue Flushing NY 11351 | |
| (718) 559-0555 | |
| Not Available |
| Full Name | Pederson Krag |
|---|---|
| Speciality | Clinic/center |
| Location | 142-02 20th Avenue, Flushing, New York |
| Authorized Official Name and Position | Malik R. Dean (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7185590555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pederson Krag 142-02 20th Avenue Flushing NY 11351 Ph: (718) 559-0555 | Pederson Krag 142-02 20th Avenue Flushing NY 11351 Ph: (718) 559-0555 |
| NPI Number | 1669843413 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 10/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669843413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 089076 (New York) | Primary |
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