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General NPI Number Information
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NPI Number | 1467573667
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Entity Type | Organization
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Legal Business Name | PRIVILEGE MEDICAL CARE PC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 3547 JUNCTION BLVD
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City | CORONA
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State | NY
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Zip | 11368-1742
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Country | US
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Telephone | 718-779-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 3547 JUNCTION BLVD
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City | CORONA
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State | NY
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Zip | 11368-1742
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Country | US
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Telephone | 718-779-6800
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANTHONY C. BOTTONE
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Credential | MD
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Telephone | 718-779-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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