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General NPI Number Information
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NPI Number | 1114244415
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Entity Type | Organization
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Legal Business Name | ADVANCED CLINICAL PHYSICIANS, P.L.L.C
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 11203 QUEENS BLVD STE 200
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-268-8383
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Fax | 718-268-6033
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Provider Business Mailing Address
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Address Line | 11203 QUEENS BLVD STE 200
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-268-8383
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Fax | 718-268-6033
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Authorized Official
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Title or Position | CEO
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Name | DR. VARUZHAN DOVLATYAN
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Credential |
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Telephone | 718-268-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | AAAASF # 3728
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License Number State | NY
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