Optimum Primary Care Medical PC
Internal Medicine in Ridgewood, NY. Organization (NPI-2).
NPI number1043563554
StatusActive
Last updated in NPPESOct 22, 2012
Details
- NPI
- 1043563554
- Entity type
- Organization (NPI-2)
- Legal business name
- Optimum Primary Care Medical PC
- Organization subpart
- No
- Enumeration date
- Oct 22, 2012
- Last updated
- Oct 22, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
311 St. Nicholas AvenueRidgewood, NY 11385
Phone 718-766-5150
Mailing address
52 Woodhollow RdRoslyn Heights, NY 11577-2217
Phone 516-361-4600
Authorized official
Mohammad Aslam
M,d,
5163614600
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