Healthcare Provider Details

I. General information

NPI: 1508932443
Provider Name (Legal Business Name): REST MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3728 77TH ST
JACKSON HEIGHTS NY
11372-6630
US

IV. Provider business mailing address

3728 77TH ST
JACKSON HEIGHTS NY
11372-6630
US

V. Phone/Fax

Practice location:
  • Phone: 718-335-7378
  • Fax: 718-335-1071
Mailing address:
  • Phone: 718-335-7378
  • Fax: 718-335-1071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SULTAN AHMED
Title or Position: MD
Credential:
Phone: 718-335-7378