Healthcare Provider Details

I. General information

NPI: 1336990308
Provider Name (Legal Business Name): EAST FLUSHING MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8713 MYRTLE AVE
GLENDALE NY
11385-7847
US

IV. Provider business mailing address

8713 MYRTLE AVE
GLENDALE NY
11385-7847
US

V. Phone/Fax

Practice location:
  • Phone: 718-971-1020
  • Fax: 718-971-1698
Mailing address:
  • Phone: 718-971-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEKSEY ETINGER
Title or Position: OWNER
Credential:
Phone: 718-971-1020