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General NPI Number Information
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NPI Number | 1285921163
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Entity Type | Organization
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Legal Business Name | EZ CARE MEDICAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 9720 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2210
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Country | US
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Telephone | 718-850-0550
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Fax | 718-850-0550
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Provider Business Mailing Address
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Address Line | 10115 WOODHAVEN BLVD
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City | OZONE PARK
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State | NY
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Zip | 11416-2314
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Country | US
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Telephone | 718-848-7481
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Fax | 718-848-7481
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Authorized Official
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Title or Position | PRESIDENT
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Name | AKHTAR ALI
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Credential | MD
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Telephone | 718-848-7481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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