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General NPI Number Information
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NPI Number | 1215243845
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Entity Type | Organization
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Legal Business Name | PRO CARE MEDICAL P.C.
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 09/06/2010
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Provider Practice Location Address
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Address Line | 14022 BEECH AVE STE 2C
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City | FLUSHING
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State | NY
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Zip | 11355-2821
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Country | US
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Telephone | 516-637-1831
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Fax |
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Provider Business Mailing Address
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Address Line | 34 CARRIAGE RD
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City | ROSLYN
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State | NY
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Zip | 11576-3118
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Country | US
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Telephone | 516-637-1831
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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. VIREN GORDHANBHAI AMIN
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Credential | M.D.
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Telephone | 516-637-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 249189
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 246431
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License Number State | NY
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