| Active Care Physician Pc | |
|
70 Bowery Suite 404 New York NY 10013-4607 | |
| (212) 343-8290 | |
| (212) 343-8328 |
| Full Name | Active Care Physician Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 70 Bowery, New York, New York |
| Authorized Official Name and Position | Blanche Sau Leung (PRESIDENT) |
| Authorized Official Contact | 2123438290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Care Physician Pc 70 Bowery Suite 404 New York NY 10013-4607 Ph: (212) 343-8290 | Active Care Physician Pc 70 Bowery Suite 404 New York NY 10013-4607 Ph: (212) 343-8290 |
| NPI Number | 1912244567 |
|---|---|
| Provider Enumeration Date | 01/15/2013 |
| Last Update Date | 01/15/2013 |
| Medicare PECOS PAC ID | 8921244716 |
|---|---|
| Medicare Enrollment ID | O20130424000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912244567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 213122 (New York) | Primary |
| Provider Name | Blanche S Leung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124082011 PECOS PAC ID: 4082629837 Enrollment ID: I20060215000241 |
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