| Smart Health Medical, P.c. | |
|
83-45 Dongan Ave Queens NY 11373-3755 | |
| (646) 258-2574 | |
| Not Available |
| Full Name | Smart Health Medical, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 83-45 Dongan Ave, Queens, New York |
| Authorized Official Name and Position | Vi Quach (DIRECTOR) |
| Authorized Official Contact | 6462582574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smart Health Medical, P.c. 160 E 84th St 10l New York NY 10028-2008 Ph: (646) 258-2574 | Smart Health Medical, P.c. 83-45 Dongan Ave Queens NY 11373-3755 Ph: (646) 258-2574 |
| NPI Number | 1821301375 |
|---|---|
| Provider Enumeration Date | 07/26/2010 |
| Last Update Date | 07/26/2010 |
| Medicare PECOS PAC ID | 7517155179 |
|---|---|
| Medicare Enrollment ID | O20101223000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821301375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 211187 (New York) | Secondary |
| 207R00000X | Internal Medicine | 246652 (New York) | Primary |
| Provider Name | Punyadech Photangtham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083700926 PECOS PAC ID: 8426066036 Enrollment ID: I20060323000371 |
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