MEDICARE: HISPANIC MEDICAL HEALTH P.C.

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1851789978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HISPANIC MEDICAL HEALTH P.C.

Provider Business Mailing Address
First Line	:	5041 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-1131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5041 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-1131
Country	:	US
Telephone Number	:	917-557-5510
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KONSTANTINOS ZARKADAS
Credential	:	M.D.
Telephone Number	:	347-613-5875

Provider Enumeration Date	:	12/23/2014
Last Update Date	:	12/23/2014

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