Organization · NPI-2

9317 Medical Office PC

Internal Medicine · Jackson Heights, NY

NPI number1871707372

StatusActive

Last updated in NPPESJun 21, 2024

Details

NPI: 1871707372
Entity type: Organization (NPI-2)
Legal business name: 9317 Medical Office PC
Organization subpart: No
Enumeration date: May 10, 2007
Certification date: Jun 21, 2024
Last updated: Jun 21, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
208000000X	Pediatrics	–	–

Practice location

9317 Roosevelt Ave
Jackson Heights, NY 11372-7943

Phone 718-446-0270 · Fax 718-446-5939

Mailing address

9317 Roosevelt Ave
Jackson Heights, NY 11372-7943

Phone 718-446-0270 · Fax 718-446-5939

Other practice locations

2645 Sw 37th Ave Ste 701
Miami, FL 33133-2745

Phone 718-489-9527 · Fax 718-446-5939

Authorized official

Sandra J Marrero
Office Manager
7184460270

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