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General NPI Number Information
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NPI Number | 1740461334
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Entity Type | Organization
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Legal Business Name | PRIME CARE MEDICAL GROUP PC
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Dates
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Enumeration Date | 11/25/2007
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 16806 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4341
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Country | US
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Telephone | 718-739-7400
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Fax | 718-739-7413
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Provider Business Mailing Address
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Address Line | 16806 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4341
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Country | US
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Telephone | 718-739-7400
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Fax | 718-739-7413
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Authorized Official
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Title or Position | OWNER
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Name | IFFAT ARA SADIQUE
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Credential | MD
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Telephone | 718-739-7400
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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 | 230830
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 242628
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 244121
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N005475
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 229868
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License Number State | NY
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