96Th Street Junction Blvd Medical Pc

LBN: 96Th Street Junction Blvd Medical Pc
96Th Street Junction Blvd Medical Pc is an health care organization with primary practice located at 5548 96Th St , Corona NY 11368. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. 96Th Street Junction Blvd Medical Pc can be contacted via phone (718) 606-1199, or through Rucker, Wilder via phone (718) 606-1199.

Contact Information

Primary practice address
5548 96Th St Corona NY 11368
Phone: (718) 606-1199
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rucker, Wilder Doctor of Medicine (MD)
Phone: (718) 606-1199

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1588157788
LBN Legal business name 96Th Street Junction Blvd Medical Pc
DBA Doing business as
Authorized official Rucker, Wilder Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2018
Last updated Aug 13th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers