| Personal Care Np Adult Health Practice Pllc | |
|
19105 Jamaica Ave Hollis NY 11423-2527 | |
| (718) 217-7111 | |
| (718) 217-7113 |
| Full Name | Personal Care Np Adult Health Practice Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19105 Jamaica Ave, Hollis, New York |
| Authorized Official Name and Position | Ralph Edouard (NURSE PRACTIONER) |
| Authorized Official Contact | 7182177111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Care Np Adult Health Practice Pllc 19105 Jamaica Ave Hollis NY 11423-2527 Ph: (718) 217-7111 | Personal Care Np Adult Health Practice Pllc 19105 Jamaica Ave Hollis NY 11423-2527 Ph: (718) 217-7111 |
| NPI Number | 1063871523 |
|---|---|
| Provider Enumeration Date | 02/12/2016 |
| Last Update Date | 10/07/2016 |
| Medicare PECOS PAC ID | 7810285186 |
|---|---|
| Medicare Enrollment ID | O20161019002625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063871523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3053411 (New York) | Primary |
| Provider Name | Ralph Edouard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598058224 PECOS PAC ID: 5890964498 Enrollment ID: I20110817000189 |
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