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General NPI Number Information
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NPI Number | 1598084709
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Entity Type | Organization
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Legal Business Name | GOOD CARE MEDICAL,P.C.
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 4233 KISSENA BLVD 1A
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City | FLUSHING
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State | NY
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Zip | 11355-3241
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Country | US
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Telephone | 718-888-7122
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Fax | 718-888-7172
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Provider Business Mailing Address
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Address Line | 4233 KISSENA BLVD 1A
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City | FLUSHING
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State | NY
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Zip | 11355-3241
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Country | US
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Telephone | 718-888-7122
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Fax | 718-888-7172
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JING DENG
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Credential | M.D.
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Telephone | 718-888-7122
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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 | 212380
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License Number State | NY
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