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NPI Code Detail

MEDICARE: QLIMG CAMBRIA HEIGHTS MED. OFFICE

MEDICARE: QLIMG CAMBRIA HEIGHTS MED. OFFICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician
2207Q00000XFamily Medicine Physician
3207RH0003XHematology & Oncology Physician
4207RP1001XPulmonary Disease Physician
5207RR0500XRheumatology Physician
6207V00000XObstetrics & Gynecology Physician
7207W00000XOphthalmology Physician
8207X00000XOrthopaedic Surgery Physician
9208000000XPediatrics Physician
102080P0201XPediatric Allergy/Immunology Physician
112080P0205XPediatric Endocrinology Physician
12208600000XSurgery Physician
13208800000XUrology Physician
14213E00000XPodiatrist
15207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1104916865
Entity Type Code : Organization
Provider Name (Legal Business Name) : QLIMG CAMBRIA HEIGHTS MED. OFFICE
Provider Business Mailing Address
First Line : 20620 LINDEN BLVD
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-1524
Country : US
Telephone Number : 718-479-6600
Fax Number : 718-217-3546
Provider Business Practice Location Address
First Line : 1000 ZECKENDORF BLVD
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-2133
Country : US
Telephone Number : 516-542-6880
Fax Number : 516-542-5556
Authorized Official
Title or Position : DIRECTOR OF CREDENTIALING
Name : MARLENA SIMPSON
Credential : CPMSM
Telephone Number : 516-542-6880
Provider Enumeration Date : 10/13/2006
Last Update Date : 10/22/2010

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Directions to “QLIMG CAMBRIA HEIGHTS MED. OFFICE ” Practice Location

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