| Crystal Ray Medical P.c. | |
|
9614 63rd Dr Suite 200 Rego Park NY 11374-2239 | |
| (718) 896-0111 | |
| (718) 896-2161 |
| Full Name | Crystal Ray Medical P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9614 63rd Dr, Rego Park, New York |
| Authorized Official Name and Position | Marina Adelman (BILLING DEPARTMENT) |
| Authorized Official Contact | 7187437090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Ray Medical P.c. 9614 63rd Dr Suite 200 Rego Park NY 11374-2239 Ph: (718) 896-0111 | Crystal Ray Medical P.c. 9614 63rd Dr Suite 200 Rego Park NY 11374-2239 Ph: (718) 896-0111 |
| NPI Number | 1881819308 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 04/24/2015 |
| Medicare PECOS PAC ID | 0648377986 |
|---|---|
| Medicare Enrollment ID | O20070521000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881819308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| Provider Name | Igor E Cohen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023046968 PECOS PAC ID: 6507849296 Enrollment ID: I20040611001515 |
| Provider Name | Ahmed M Maati |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205272887 PECOS PAC ID: 2062647183 Enrollment ID: I20131028000369 |
| Provider Name | Mary Grace B Francisco |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386023018 PECOS PAC ID: 3375834203 Enrollment ID: I20160623000295 |
| Provider Name | Ahmed Mohamed Kadry Hassanein |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407347156 PECOS PAC ID: 1254672736 Enrollment ID: I20190410001218 |
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