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General NPI Number Information
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NPI Number | 1669699096
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Entity Type | Organization
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Legal Business Name | JACKSON HEIGHTS MEDICAL, P.C.
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 3743 76TH ST 1ST FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6533
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Country | US
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Telephone | 718-396-0200
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Fax | 718-505-2819
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Provider Business Mailing Address
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Address Line | 3743 76TH ST 1ST FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6533
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Country | US
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Telephone | 718-396-0200
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Fax | 718-505-2819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALVIS YEE
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Credential | M.D.
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Telephone | 718-396-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 186252
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License Number State | NY
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