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General NPI Number Information
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NPI Number | 1871038315
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Entity Type | Organization
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Legal Business Name | WESTERN CARE MEDICAL PC
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 7017 37TH AVE 1ST FLR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-3922
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Country | US
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Telephone | 718-565-5600
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Fax | 718-565-5600
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Provider Business Mailing Address
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Address Line | 7017 37TH AVE 1ST FLR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-3922
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Country | US
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Telephone | 718-565-5600
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Fax | 718-565-5600
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Authorized Official
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Title or Position | M.D.
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Name | FERDOUS KHANDKER
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Credential |
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Telephone | 718-565-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 22523
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License Number State | NY
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