| Queens Medical Of New York Llc | |
|
11602 Queens Blvd Forest Hills NY 11375-7055 | |
| (718) 301-1100 | |
| (888) 621-3330 |
| Full Name | Queens Medical Of New York Llc |
|---|---|
| Speciality | Surgery |
| Location | 11602 Queens Blvd, Forest Hills, New York |
| Authorized Official Name and Position | Flora Katsnelson (OWNER) |
| Authorized Official Contact | 7183011100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Medical Of New York Llc Po Box 32 Northbrook IL 60065-0032 Ph: (718) 301-1100 | Queens Medical Of New York Llc 11602 Queens Blvd Forest Hills NY 11375-7055 Ph: (718) 301-1100 |
| NPI Number | 1730439704 |
|---|---|
| Provider Enumeration Date | 09/17/2012 |
| Last Update Date | 09/17/2012 |
| Medicare PECOS PAC ID | 3870748692 |
|---|---|
| Medicare Enrollment ID | O20130228000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730439704 | NPI | - | NPPES |
| Provider Name | Alexander Gart |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376610758 PECOS PAC ID: 0345136495 Enrollment ID: I20040225000552 |
| Provider Name | James T Riley |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1609076629 PECOS PAC ID: 6406944396 Enrollment ID: I20071109000361 |
| Provider Name | John A Babalola |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487613626 PECOS PAC ID: 6507938032 Enrollment ID: I20080627000584 |
| Provider Name | Richard Di Fiore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902000995 PECOS PAC ID: 5395836068 Enrollment ID: I20100920000323 |
| Provider Name | Robert V Shirinov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902067986 PECOS PAC ID: 2466689278 Enrollment ID: I20131223001519 |
| Provider Name | Jeromy Patterson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770877953 PECOS PAC ID: 0941514574 Enrollment ID: I20171117000529 |
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