| Revere Medical Associates, P.c. | |
|
535 Port Washington Blvd Port Washington NY 11050-4227 | |
| (516) 944-9515 | |
| Not Available |
| Full Name | Revere Medical Associates, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 535 Port Washington Blvd, Port Washington, New York |
| Authorized Official Name and Position | William S Knight (M.D.) |
| Authorized Official Contact | 5169449515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Medical Associates, P.c. 535 Port Washington Blvd Port Washington NY 11050-4227 Ph: (516) 944-9515 | Revere Medical Associates, P.c. 535 Port Washington Blvd Port Washington NY 11050-4227 Ph: (516) 944-9515 |
| NPI Number | 1548430366 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 04/01/2008 |
| Medicare PECOS PAC ID | 4082793120 |
|---|---|
| Medicare Enrollment ID | O20080501000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548430366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Emia H Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902980139 PECOS PAC ID: 4587741731 Enrollment ID: I20080411000449 |
| Provider Name | William S Knight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245314475 PECOS PAC ID: 5991884033 Enrollment ID: I20080501000008 |
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