Physician Healthcare Network,pc | |
4415 43rd Ave Apt C1 Sunnyside NY 11104-2254 | |
(718) 472-3870 | |
(718) 472-4060 |
Full Name | Physician Healthcare Network,pc |
---|---|
Speciality | Internal Medicine |
Location | 4415 43rd Ave Apt C1, Sunnyside, New York |
Authorized Official Name and Position | Ramsey John Fakhuri (PRESIDENT) |
Authorized Official Contact | 5169224029 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Physician Healthcare Network,pc 41 Walnut Ave East Norwich NY 11732-1413 Ph: (516) 922-4029 | Physician Healthcare Network,pc 4415 43rd Ave Apt C1 Sunnyside NY 11104-2254 Ph: (718) 472-3870 |
NPI Number | 1619189016 |
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Provider Enumeration Date | 05/06/2007 |
Last Update Date | 11/29/2011 |
Medicare PECOS PAC ID | 7719877000 |
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Medicare Enrollment ID | O20100208000141 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619189016 | NPI | - | NPPES |
01410553 | Medicaid | NY | |
WEK461 | Other | NY | MEDICARE # FOR NYC, NASSU |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 175168 (New York) | Primary |
Provider Name | Ramsey John Fakhuri |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215992177 PECOS PAC ID: 4587707955 Enrollment ID: I20100208000133 |
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