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General NPI Number Information
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NPI Number | 1639551070
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Entity Type | Organization
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Legal Business Name | WYCKOFF HEIGHTS MEDICAL CENTER
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 10460 QUEENS BLVD APT 10P
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City | FOREST HILLS
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State | NY
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Zip | 11375-7318
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Country | US
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Telephone | 586-744-9584
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Fax |
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Provider Business Mailing Address
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Address Line | 10460 QUEENS BLVD APT 10P
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City | FOREST HILLS
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State | NY
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Zip | 11375-7318
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PODIATRY
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Name | DUC VAN NGUYEN
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Credential |
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Telephone | 586-744-9584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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