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General NPI Number Information
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NPI Number | 1073676292
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Entity Type | Organization
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Legal Business Name | FIRST MED IMMEDIATE MEDICAL SERVICES OF QUEENS, P.C.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 19120 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11358-2829
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Country | US
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Telephone | 718-224-8855
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Fax | 718-631-2544
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Provider Business Mailing Address
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Address Line | 1345 RXR PLZ FL 13
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City | UNIONDALE
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State | NY
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Zip | 11556-1301
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Country | US
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Telephone | 516-453-0435
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Fax | 646-846-3283
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY A BRUMBERG
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Credential | MD
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Telephone | 718-224-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 152659
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License Number State | NY
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