Healthcare Provider Details

I. General information

NPI: 1033503578
Provider Name (Legal Business Name): CHOICE MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NEWKIRK PLZ STE 2
BROOKLYN NY
11226-6525
US

IV. Provider business mailing address

10414 113TH ST
SOUTH RICHMOND HILL NY
11419-2506
US

V. Phone/Fax

Practice location:
  • Phone: 718-540-6997
  • Fax: 518-557-8164
Mailing address:
  • Phone: 412-452-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number265529
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MANSOOR KHAN
Title or Position: CEO
Credential: DO
Phone: 929-278-3806