MEDICARE: TOTAL GLOBAL MEDICAL 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	2085R0202X	Diagnostic Radiology Physician	140440	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140440	OTHER	NY	NYS LICENSE

General Provider Information

NPI Number	:	1669669198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL GLOBAL MEDICAL PC

Provider Business Mailing Address
First Line	:	11960 METROPOLITAN AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2606
Country	:	US
Telephone Number	:	718-850-7200
Fax Number	:	718-850-7222

Provider Business Practice Location Address
First Line	:	11960 METROPOLITAN AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2606
Country	:	US
Telephone Number	:	718-850-7200
Fax Number	:	718-850-7222

Authorized Official
Title or Position	:	OWNER
Name	:	CLIFFORD BEINART
Credential	:	MD
Telephone Number	:	718-850-7200

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	09/28/2007

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