| Lefrak City Family Care,pc | |
|
9815 Horace Harding Expy Corona NY 11368-4249 | |
| (718) 699-8500 | |
| Not Available |
| Full Name | Lefrak City Family Care,pc |
|---|---|
| Speciality | Family Medicine |
| Location | 9815 Horace Harding Expy, Corona, New York |
| Authorized Official Name and Position | Izolda Mikhaylov (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7184690890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lefrak City Family Care,pc 785 Van Dam St Valley Stream NY 11581-3523 Ph: (718) 469-0890 | Lefrak City Family Care,pc 9815 Horace Harding Expy Corona NY 11368-4249 Ph: (718) 699-8500 |
| NPI Number | 1477574119 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9830610955 |
|---|---|
| Medicare Enrollment ID | O20250305002938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477574119 | NPI | - | NPPES |
| 02313197 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 223885 (New York) | Primary |
| Provider Name | Izolda Mikhaylov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093734055 PECOS PAC ID: 1153307814 Enrollment ID: I20040624001699 |
| Provider Name | Andrew Rosenson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942208079 PECOS PAC ID: 9335131408 Enrollment ID: I20171024000384 |
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