MEDICARE: SUNRAY MEDICAL CARE 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	207R00000X	Internal Medicine Physician	217939	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376052621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRAY MEDICAL CARE PC

Provider Business Mailing Address
First Line	:	761 55TH STREET
Second Line	:	FL 2
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3210
Country	:	US
Telephone Number	:	718-980-3247
Fax Number	:

Provider Business Practice Location Address
First Line	:	761 55TH STREET
Second Line	:	FL 2
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3210
Country	:	US
Telephone Number	:	718-436-3497
Fax Number	:	718-436-3499

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. PING ZHOU
Credential	:	MD
Telephone Number	:	718-683-7261

Provider Enumeration Date	:	09/28/2017
Last Update Date	:	05/16/2018

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