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General NPI Number Information
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NPI Number | 1992045793
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Entity Type | Organization
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Legal Business Name | PRIMARY MEDICAL CARE SERVICES PLLC
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 9916 97TH ST
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City | OZONE PARK
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State | NY
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Zip | 11416-2509
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Country | US
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Telephone | 917-300-5402
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Fax | 917-300-5405
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Provider Business Mailing Address
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Address Line | 9916 97TH ST
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City | OZONE PARK
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State | NY
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Zip | 11416-2509
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Country | US
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Telephone | 917-300-5402
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Fax | 917-300-5405
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JOSHUA ANTHONY POWELL
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Credential | MD
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Telephone | 646-673-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 267268-1
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License Number State | NY
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