Healthcare Provider Details

I. General information

NPI: 1538575550
Provider Name (Legal Business Name): JC MEDICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 MAIN ST SUITE 312
FLUSHING NY
11355-3833
US

IV. Provider business mailing address

13420 BLOSSOM AVE FL 3
FLUSHING NY
11355-4639
US

V. Phone/Fax

Practice location:
  • Phone: 718-865-8648
  • Fax:
Mailing address:
  • Phone: 718-869-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number273276
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number273276
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number273276
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number273276
License Number StateNY

VIII. Authorized Official

Name: DR. JIANQING ZHANG
Title or Position: OWNER
Credential: M.D.
Phone: 718-869-2567