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NPI Code Detail

MEDICARE: QUEENS DIABETES & ENDOCRINOLOGY, P.C.

MEDICARE: QUEENS DIABETES & ENDOCRINOLOGY, P.C.
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
1174400000XSpecialist

General Provider Information

NPI Number : 1699707042
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUEENS DIABETES & ENDOCRINOLOGY, P.C.
Provider Business Mailing Address
First Line : 5945 161ST ST
Second Line :
City : FLUSHING
State : NY
Zip : 11365-1414
Country : US
Telephone Number : 718-762-3111
Fax Number : 718-353-6315
Provider Business Practice Location Address
First Line : 5945 161ST ST
Second Line :
City : FLUSHING
State : NY
Zip : 11365-1414
Country : US
Telephone Number : 718-762-3111
Fax Number : 718-353-6315
Authorized Official
Title or Position : CEO
Name : DANIEL LORBER
Credential : M.D
Telephone Number : 718-762-3073
Provider Enumeration Date : 07/07/2006
Last Update Date : 08/22/2020

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