MEDICARE: PATIENT CENTERED MEDICAL SERVICE PC

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
1	261QU0200X	Urgent Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174322580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT CENTERED MEDICAL SERVICE PC

Provider Business Mailing Address
First Line	:	21304 NORTHERN BLVD
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3344
Country	:	US
Telephone Number	:	929-744-1197
Fax Number	:

Provider Business Practice Location Address
First Line	:	21304 NORTHERN BLVD
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3344
Country	:	US
Telephone Number	:	929-744-1197
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASMIN DENT
Credential	:
Telephone Number	:	212-729-3128

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/10/2025

Similar Medicare Providers

1184582132 — ROWEN KIRRON FREDERICK FNP
Practice Location Address:

21304 NORTHERN BLVD
BAYSIDE, NY
11361-3344

Practice Phone: 929-744-1197
Practice Fax:

1831265511 — PRIMARY CARE ASSOCIATES, LLP
Practice Location Address:

3344 BELL BLVD
BAYSIDE, NY
11361-1738

Practice Phone: 718-229-3344
Practice Fax: 718-224-9527

1043672595 — JACKLYN MARIE IANNITTI OTR/L
Practice Location Address:

3436 BELL BLVD
BAYSIDE, NY
11361-2375

Practice Phone: 917-574-5415
Practice Fax:

1750624458 — GORDON WANG DDS
Practice Location Address:

20726 NORTHERN BLVD STE 2B
BAYSIDE, NY
11361-3147

Practice Phone: 718-885-4323
Practice Fax:

1386467512 — GW DENTAL STUDIO PC
Practice Location Address:

20726 NORTHERN BLVD STE 2B
BAYSIDE, NY
11361-3147

Practice Phone: 718-885-4323
Practice Fax: 718-885-4325

1912864331 — ESSENCE OF BEAUTY MED SPA
Practice Location Address:

3850 BELL BLVD , SUITE A2
BAYSIDE, NY
11361

Practice Phone: 718-589-4541
Practice Fax: 718-893-8511

Directions to “PATIENT CENTERED MEDICAL SERVICE PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.