| Prime Medical Care, Pc | |
|
11808 101st Ave South Richmond Hill NY 11419-1230 | |
| (718) 441-0410 | |
| Not Available |
| Full Name | Prime Medical Care, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 11808 101st Ave, South Richmond Hill, New York |
| Authorized Official Name and Position | Tahira Ghaffar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7184410410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medical Care, Pc 36 Felton Ave Valley Stream NY 11580-3902 Ph: (631) 355-9052 | Prime Medical Care, Pc 11808 101st Ave South Richmond Hill NY 11419-1230 Ph: (718) 441-0410 |
| NPI Number | 1215202874 |
|---|---|
| Provider Enumeration Date | 03/15/2012 |
| Last Update Date | 03/15/2012 |
| Medicare PECOS PAC ID | 5294998472 |
|---|---|
| Medicare Enrollment ID | O20120525000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215202874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tahira F Ghaffar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912179458 PECOS PAC ID: 5294892485 Enrollment ID: I20090313000454 |
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