Healthcare Provider Details

I. General information

NPI: 1730336413
Provider Name (Legal Business Name): ALL IN ONE MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5515 VAN CLEEF ST
CORONA NY
11368-3907
US

IV. Provider business mailing address

13876 QUEENS BLVD FL 1
BRIARWOOD NY
11435-2930
US

V. Phone/Fax

Practice location:
  • Phone: 718-393-3075
  • Fax: 718-393-3096
Mailing address:
  • Phone: 718-850-6345
  • Fax: 718-559-4895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN CLAUDE DEMETRIUS
Title or Position: DIRECTOR
Credential: M.D.
Phone: 718-393-3075