MEDICARE: DOC FLOW MEDICAL PC

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	:	1790436988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOC FLOW MEDICAL PC

Provider Business Mailing Address
First Line	:	3462 9TH ST APT 1
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-5166
Country	:	US
Telephone Number	:	718-709-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3462 9TH ST APT 1
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-5166
Country	:	US
Telephone Number	:	718-709-1600
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. LESLIE AUQUILLA
Credential	:	MD
Telephone Number	:	917-478-1668

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

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Directions to “DOC FLOW MEDICAL PC ” Practice Location

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