Healthcare Provider Details

I. General information

NPI: 1184937278
Provider Name (Legal Business Name): NORTH FLUSHING PRIMARY MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2010
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 UNION ST
FLUSHING NY
11354-3049
US

IV. Provider business mailing address

3202 UNION ST
FLUSHING NY
11354-3049
US

V. Phone/Fax

Practice location:
  • Phone: 718-462-8080
  • Fax:
Mailing address:
  • Phone: 718-462-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number023460
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number023460
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number169313
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number191443
License Number StateNY

VIII. Authorized Official

Name: ANA ROMEO
Title or Position: PRESIDENT
Credential: D.O.
Phone: 718-762-8080