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General NPI Number Information
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NPI Number | 1194092627
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Entity Type | Organization
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Legal Business Name | LOGISTICS MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 10721 QUEENS BLVD SUITE 4
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City | FOREST HILLS
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State | NY
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Zip | 11375-4413
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Country | US
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Telephone | 718-302-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 10721 QUEENS BLVD SUITE 4
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City | FOREST HILLS
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State | NY
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Zip | 11375-4413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL COHEN
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Credential | M.D.
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Telephone | 718-302-1111
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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 |
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License Number State |
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