Metro Physical Medicine Pc

LBN: Metro Physical Medicine Pc
Metro Physical Medicine Pc is an health care organization with primary practice located at 10825 Merrick Blvd , Jamaica NY 11433-2906. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Metro Physical Medicine Pc can be contacted via phone (718) 658-9700, or through Theagene, Samuel via phone (718) 658-9700.

Contact Information

Primary practice address
10825 Merrick Blvd Jamaica NY 11433-2906
Phone: (718) 658-9700
Fax: (718) 658-9703
Website:
Map and Directions
Authorized official contact:
Name: Theagene, Samuel Doctor of Medicine (MD)
Phone: (718) 658-9700

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 194218 New York

Profile Details

NPI number 1679903413
LBN Legal business name Metro Physical Medicine Pc
DBA Doing business as
Authorized official Theagene, Samuel Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2013
Last updated Nov 14th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679903413 NPPES
New York MEDICAID 135761803

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