| Firsthand Health Of Kentucky Psc | |
|
524 Broadway Fl 11 New York NY 10012-4471 | |
| (844) 378-4263 | |
| Not Available |
| Full Name | Firsthand Health Of Kentucky Psc |
|---|---|
| Speciality | General Practice |
| Location | 524 Broadway Fl 11, New York, New York |
| Authorized Official Name and Position | Joseph Parks (MD) |
| Authorized Official Contact | 5738648733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firsthand Health Of Kentucky Psc 1032 E Brandon Blvd # 4567 Brandon FL 33511-5509 Ph: (844) 378-4263 | Firsthand Health Of Kentucky Psc 524 Broadway Fl 11 New York NY 10012-4471 Ph: (844) 378-4263 |
| NPI Number | 1477301141 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 1456885136 |
|---|---|
| Medicare Enrollment ID | O20241118002275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477301141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Joseph Parks |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003898495 PECOS PAC ID: 5496668204 Enrollment ID: I20220526002954 |
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