| Five Star Medical Office Pc | |
|
10407 Metropolitan Ave Forest Hills NY 11375-6735 | |
| (718) 576-4652 | |
| (516) 710-7846 |
| Full Name | Five Star Medical Office Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10407 Metropolitan Ave, Forest Hills, New York |
| Authorized Official Name and Position | Celeste Daye (VP REVENUE MANAGEMENT) |
| Authorized Official Contact | 4705533591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Five Star Medical Office Pc Po Box 801280 Kansas City MO 64180-1280 Ph: (718) 576-4652 | Five Star Medical Office Pc 10407 Metropolitan Ave Forest Hills NY 11375-6735 Ph: (718) 576-4652 |
| NPI Number | 1760731459 |
|---|---|
| Provider Enumeration Date | 09/10/2012 |
| Last Update Date | 03/15/2023 |
| Medicare PECOS PAC ID | 8820248016 |
|---|---|
| Medicare Enrollment ID | O20121024000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760731459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 265676 (New York) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ngozi Onuachu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174901078 PECOS PAC ID: 4981946670 Enrollment ID: I20190429002611 |
| Provider Name | Olga Yushuvayeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013579614 PECOS PAC ID: 0840623997 Enrollment ID: I20191204001854 |
| Provider Name | Alan Abrams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619082674 PECOS PAC ID: 9133156243 Enrollment ID: I20210412002394 |
| Provider Name | Maria Bangieva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316313083 PECOS PAC ID: 0143638437 Enrollment ID: I20210427000925 |
| Provider Name | Julia Jezmir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114418670 PECOS PAC ID: 1759626351 Enrollment ID: I20211001001638 |
| Provider Name | Polina Verbitsky-havasov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053078386 PECOS PAC ID: 4880086131 Enrollment ID: I20220118000709 |
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