| Up To Date Medical Healthcare Pllc | |
|
2747 Crescent St Ste 104 Astoria NY 11102-3142 | |
| (718) 204-7550 | |
| (718) 204-7566 |
| Full Name | Up To Date Medical Healthcare Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2747 Crescent St Ste 104, Astoria, New York |
| Authorized Official Name and Position | Jimmy Katechis (PHYSICIAN) |
| Authorized Official Contact | 7182047550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Up To Date Medical Healthcare Pllc 2747 Crescent St Ste 104 Astoria NY 11102-3142 Ph: (718) 204-7550 | Up To Date Medical Healthcare Pllc 2747 Crescent St Ste 104 Astoria NY 11102-3142 Ph: (718) 204-7550 |
| NPI Number | 1700942406 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 3870594807 |
|---|---|
| Medicare Enrollment ID | O20070118000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700942406 | NPI | - | NPPES |
| 0273915 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 237602 (New York) | Primary |
| Provider Name | Jimmy Katechis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518060862 PECOS PAC ID: 0941201834 Enrollment ID: I20070119000182 |
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