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General NPI Number Information
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NPI Number | 1548410780
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Entity Type | Organization
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Legal Business Name | DREAM MEDICAL CARE, PC
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 10311 NORTHERN BLVD
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City | CORONA
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State | NY
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Zip | 11368-1136
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Country | US
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Telephone | 718-205-0500
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Fax | 718-205-0505
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Provider Business Mailing Address
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Address Line | 10311 NORTHERN BLVD
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City | CORONA
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State | NY
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Zip | 11368-1136
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Country | US
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Telephone | 718-205-0500
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Fax | 718-205-0505
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Authorized Official
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Title or Position | MD
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Name | DR. KAMAL KHAN
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Credential |
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Telephone | 718-205-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 233937
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License Number State | NY
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