=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902236433
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAFE MEDICAL CARE, PLLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2013
-----------------------------------------------------
Last Update Date | 11/19/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9747 77TH ST FIRST FLOOR
-----------------------------------------------------
City | OZONE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11416-1902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-726-7301
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6574 SAUNDERS ST 6E
-----------------------------------------------------
City | REGO PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11374-4254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-726-7301
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. MOHAMMED A WAHID
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 646-726-7301
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 258061
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------