Healthcare Provider Details

I. General information

NPI: 1356521298
Provider Name (Legal Business Name): PROMPT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2543 STEINWAY ST
ASTORIA NY
11103-3701
US

IV. Provider business mailing address

2543 STEINWAY ST
ASTORIA NY
11103-3701
US

V. Phone/Fax

Practice location:
  • Phone: 718-706-8060
  • Fax: 718-706-8650
Mailing address:
  • Phone: 718-706-8060
  • Fax: 718-706-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number224801
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number224801
License Number StateNY

VIII. Authorized Official

Name: DR. KHALED OMAR ELBANNA
Title or Position: PRESIDENT
Credential: MD
Phone: 718-706-8060