Organization · NPI-2

410 Medical, P.C

Internal Medicine · Jamaica, NY

NPI number1245628262
StatusActive
Last updated in NPPESDec 29, 2014

Details

NPI
1245628262
Entity type
Organization (NPI-2)
Legal business name
410 Medical, P.C
Organization subpart
No
Enumeration date
Dec 29, 2014
Last updated
Dec 29, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineA188292-1NYYes

Practice location

9050 Parsons Blvd Ste 410
Jamaica, NY 11432-6052

Phone 212-470-0360

Mailing address

9050 Parsons Blvd Ste 410
Jamaica, NY 11432-6052

Phone 212-470-0360

Authorized official

Steven Wong
Owner
2124700360

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