| East Elmhurst Primary Medical Care, Pllc | |
|
7535 31st Ave Suite 200 East Elmhurst NY 11370-1857 | |
| (516) 755-0390 | |
| (516) 755-2297 |
| Full Name | East Elmhurst Primary Medical Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7535 31st Ave, East Elmhurst, New York |
| Authorized Official Name and Position | Carl A Nicoleau (PRESIDENT) |
| Authorized Official Contact | 3475150123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Elmhurst Primary Medical Care, Pllc 7535 31st Ave Suite 200 East Elmhurst NY 11370-1857 Ph: (347) 515-0123 | East Elmhurst Primary Medical Care, Pllc 7535 31st Ave Suite 200 East Elmhurst NY 11370-1857 Ph: (516) 755-0390 |
| NPI Number | 1851347900 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 1456622778 |
|---|---|
| Medicare Enrollment ID | O20170804002289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851347900 | NPI | - | NPPES |
| 180270 | Other | NY | NYS MEDICAL LIC # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 180270 (New York) | Secondary |
| 207RS0012X | Internal Medicine - Sleep Medicine | 180270 (New York) | Primary |
| Provider Name | Robert D. Solomon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720050040 PECOS PAC ID: 5890780209 Enrollment ID: I20040415001272 |
| Provider Name | Mujibur R Majumder |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316988165 PECOS PAC ID: 6709843659 Enrollment ID: I20041213000863 |
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