Yeahseon Bruinings Md Fam Pract | |
3438 Bell Blvd Ph Floor 5 Bayside NY 11361-1730 | |
(718) 360-5768 | |
Not Available |
Full Name | Yeahseon Bruinings Md Fam Pract |
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Speciality | Family Medicine |
Location | 3438 Bell Blvd, Bayside, New York |
Authorized Official Name and Position | Yeahseon Choi Bruinings (MEMBER , PHYSICIAN) |
Authorized Official Contact | 7183605768 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Yeahseon Bruinings Md Fam Pract 3438 Bell Blvd Ph Floor 5 Bayside NY 11361-1730 Ph: (718) 360-5768 | Yeahseon Bruinings Md Fam Pract 3438 Bell Blvd Ph Floor 5 Bayside NY 11361-1730 Ph: (718) 360-5768 |
NPI Number | 1669676466 |
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Provider Enumeration Date | 06/14/2007 |
Last Update Date | 01/21/2013 |
Medicare PECOS PAC ID | 3375503139 |
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Medicare Enrollment ID | O20041015000279 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669676466 | NPI | - | NPPES |
02405338 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 226709 (New York) | Primary |
Provider Name | Yeahseon C Bruinings |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770580235 PECOS PAC ID: 1658335161 Enrollment ID: I20041115001037 |
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