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NPI Code Detail

MEDICARE: HEALTHWISE MEDICAL ASSOCIATES PC

MEDICARE: HEALTHWISE MEDICAL ASSOCIATES 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
1207RN0300XNephrology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1386810885
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHWISE MEDICAL ASSOCIATES PC
Provider Business Mailing Address
First Line : 3324 77TH ST
Second Line : SUITE 2C
City : JACKSON HEIGHTS
State : NY
Zip : 11372-1219
Country : US
Telephone Number : 718-651-0601
Fax Number : 718-651-0611
Provider Business Practice Location Address
First Line : 3324 77TH ST
Second Line : SUITE 2C
City : JACKSON HEIGHTS
State : NY
Zip : 11372-1219
Country : US
Telephone Number : 718-651-0601
Fax Number : 718-651-0611
Authorized Official
Title or Position : PRESIDENT
Name : DOMINIC EMEKA ONYEMA
Credential : M.D.
Telephone Number : 718-651-0601
Provider Enumeration Date : 05/05/2008
Last Update Date : 05/05/2008

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Directions to “HEALTHWISE MEDICAL ASSOCIATES PC ” Practice Location

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