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General NPI Number Information
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NPI Number | 1679072086
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Entity Type | Organization
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Legal Business Name | ATRIA HEALTH MEDICAL, P.C.
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 9308 QUEENS BLVD # 1B1C
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City | REGO PARK
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State | NY
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Zip | 11374-1135
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Country | US
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Telephone | 718-806-1434
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Fax | 718-806-1435
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Provider Business Mailing Address
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Address Line | 9308 QUEENS BLVD # 1B1C
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City | REGO PARK
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State | NY
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Zip | 11374-1135
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Country | US
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Telephone | 718-806-1434
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Fax | 718-806-1435
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MEGHA MANIK
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Credential | M.D.
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Telephone | 718-806-1434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 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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