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General NPI Number Information
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NPI Number | 1750565412
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Entity Type | Organization
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Legal Business Name | QUEENS FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 5834 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5336
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Country | US
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Telephone | 718-358-0506
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Fax | 718-445-2169
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Provider Business Mailing Address
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Address Line | 13666 72ND AVE
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City | FLUSHING
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State | NY
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Zip | 11367-2328
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Country | US
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Telephone | 718-358-0506
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Fax | 718-445-2169
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADAM D. ZEITLIN
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Credential | D.O.
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Telephone | 718-358-0506
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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 | 227362
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License Number State | NY
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