Healthcare Provider Details

I. General information

NPI: 1871094136
Provider Name (Legal Business Name): CHOICE CARE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 SUNNYSIDE BLVD STE 100
PLAINVIEW NY
11803-1539
US

IV. Provider business mailing address

131 SUNNYSIDE BLVD STE 100
PLAINVIEW NY
11803-1539
US

V. Phone/Fax

Practice location:
  • Phone: 718-478-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SIMA ANAND
Title or Position: OWNER
Credential: MD
Phone: 718-478-4700