MEDICARE: JHMC DIAGNOSTIC AND TREATMENT CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207N00000X	Dermatology Physician
2	207R00000X	Internal Medicine Physician
3	207RR0500X	Rheumatology Physician
4	207T00000X	Neurological Surgery Physician
5	207V00000X	Obstetrics & Gynecology Physician
6	207W00000X	Ophthalmology Physician
7	208000000X	Pediatrics Physician
8	208600000X	Surgery Physician
9	208800000X	Urology Physician
10	213E00000X	Podiatrist
11	207Q00000X	Family Medicine Physician

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	:	1821045485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JHMC DIAGNOSTIC AND TREATMENT CENTER

Provider Business Mailing Address
First Line	:	80 MARCUS DR
Second Line	:	PROVIDER ENROLLMENT
City	:	MELVILLE
State	:	NY
Zip	:	11747-4230
Country	:	US
Telephone Number	:	631-391-7700
Fax Number	:	631-454-4163

Provider Business Practice Location Address
First Line	:	11120 MERRICK BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11433-4016
Country	:	US
Telephone Number	:	718-206-9888
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	FREDERICK BEEKMAN
Credential	:
Telephone Number	:	718-206-7001

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/30/2016

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Directions to “JHMC DIAGNOSTIC AND TREATMENT CENTER ” Practice Location

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