| Garden Medical Consulting Pllc | |
|
19615 75th Ave Fresh Meadows NY 11366-1737 | |
| (718) 969-4454 | |
| (718) 413-2167 |
| Full Name | Garden Medical Consulting Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 19615 75th Ave, Fresh Meadows, New York |
| Authorized Official Name and Position | Daniel Khaldarov (SECRETARY) |
| Authorized Official Contact | 9179439454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden Medical Consulting Pllc 19615 75th Ave Fresh Meadows NY 11366-1737 Ph: (718) 969-4454 | Garden Medical Consulting Pllc 19615 75th Ave Fresh Meadows NY 11366-1737 Ph: (718) 969-4454 |
| NPI Number | 1487444386 |
|---|---|
| Provider Enumeration Date | 05/12/2025 |
| Last Update Date | 05/12/2025 |
| Certification Date | 05/12/2025 |
| Medicare PECOS PAC ID | 4183143209 |
|---|---|
| Medicare Enrollment ID | O20250522000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487444386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ulyana Khaldarov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366580367 PECOS PAC ID: 0648337840 Enrollment ID: I20090609000429 |
| Provider Name | Vitaliy Khaldarov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609851195 PECOS PAC ID: 1759413867 Enrollment ID: I20100724000007 |
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