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General NPI Number Information
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NPI Number | 1821301375
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Entity Type | Organization
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Legal Business Name | SMART HEALTH MEDICAL, P.C.
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 83-45 DONGAN AVE
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City | QUEENS
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State | NY
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Zip | 11373-3755
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Country | US
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Telephone | 646-258-2574
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Fax |
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Provider Business Mailing Address
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Address Line | 160 E 84TH ST 10L
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City | NEW YORK
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State | NY
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Zip | 10028-2008
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Country | US
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Telephone | 646-258-2574
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. VI QUACH
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Credential | MD
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Telephone | 646-258-2574
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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 | 211187
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License Number State | NY
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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 | 246652
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License Number State | NY
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