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General NPI Number Information
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NPI Number | 1740583764
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Entity Type | Organization
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Legal Business Name | METROPLUS HEALTH PLAN
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 17545 88TH AVE APT # 5B
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City | JAMAICA
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State | NY
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Zip | 11432-5759
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Country | US
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Telephone | 347-484-6653
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Fax |
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Provider Business Mailing Address
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Address Line | 17545 88TH AVE APT # 5B
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City | JAMAICA
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State | NY
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Zip | 11432-5759
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Country | US
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Telephone | 347-484-6653
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MRS. SHAMIM BEGUM
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Credential | MD,FACP
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Telephone | 718-526-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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