MEDICARE: PCR PHYSICIAN PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184243040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PCR PHYSICIAN PLLC

Provider Business Mailing Address
First Line	:	117 GREENWAY W
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-2226
Country	:	US
Telephone Number	:	909-757-8314
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 GREENWAY W
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-2226
Country	:	US
Telephone Number	:	909-757-8314
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KAREEM ABED
Credential	:	MD
Telephone Number	:	609-222-1198

Provider Enumeration Date	:	04/10/2020
Last Update Date	:	04/10/2020

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Directions to “PCR PHYSICIAN PLLC ” Practice Location

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