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General NPI Number Information
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NPI Number | 1194005991
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Entity Type | Organization
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Legal Business Name | CENTURY MEDICAL CARE, PC
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 9917 63 ROAD
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City | REGO PARK
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State | NY
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Zip | 11374-1939
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Country | US
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Telephone | 718-275-4848
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Fax | 718-676-2558
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Provider Business Mailing Address
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Address Line | 9841 64TH RD APT 7G
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City | REGO PARK
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State | NY
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Zip | 11374-3446
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Country | US
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Telephone | 646-258-7405
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZACHARY RIBOTI
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Credential |
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Telephone | 646-258-7405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number |
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License Number State |
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