| Sugrim Medical Office Pllc | |
|
13106 Liberty Ave South Richmond Hill NY 11419-3124 | |
| (718) 322-5322 | |
| (718) 322-5323 |
| Full Name | Sugrim Medical Office Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 13106 Liberty Ave, South Richmond Hill, New York |
| Authorized Official Name and Position | Surendra Sugrim (OWNER) |
| Authorized Official Contact | 7183225322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugrim Medical Office Pllc 4717 157th St Flushing NY 11355-2345 Ph: () - | Sugrim Medical Office Pllc 13106 Liberty Ave South Richmond Hill NY 11419-3124 Ph: (718) 322-5322 |
| NPI Number | 1659676757 |
|---|---|
| Provider Enumeration Date | 01/20/2011 |
| Last Update Date | 05/26/2011 |
| Medicare PECOS PAC ID | 2860675642 |
|---|---|
| Medicare Enrollment ID | O20110401000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659676757 | NPI | - | NPPES |
| 03331257 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 254420 (New York) | Primary |
| Provider Name | Muntaz Ahmad Majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730258682 PECOS PAC ID: 9032304688 Enrollment ID: I20101109001285 |
| Provider Name | Surendra Sugrim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033341185 PECOS PAC ID: 5496938276 Enrollment ID: I20110401000114 |
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