Organization · NPI-2

5509 Medical Services PC

Internal Medicine · Forest Hills, NY

NPI number1417558362
StatusActive
Last updated in NPPESNov 6, 2020

Details

NPI
1417558362
Entity type
Organization (NPI-2)
Legal business name
5509 Medical Services PC
Organization subpart
No
Enumeration date
Nov 6, 2020
Certification date
Nov 6, 2020
Last updated
Nov 6, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

10814 72nd Ave Ste 4
Forest Hills, NY 11375-5301

Phone 718-520-8480

Mailing address

10814 72nd Ave Ste 4
Forest Hills, NY 11375-5301

Phone 718-520-8480

Authorized official

Gregory Silver
President
7185208480

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