| Iyar Medical Pc | |
|
7235 112th St Suite # Pr9, Forest Hills NY 11375-5469 | |
| (877) 849-4917 | |
| (877) 949-4917 |
| Full Name | Iyar Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7235 112th St, Forest Hills, New York |
| Authorized Official Name and Position | Nikolai Lagoduke (OWNER) |
| Authorized Official Contact | 8778494917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iyar Medical Pc 7235 112th St Suite # Pr9, Forest Hills NY 11375-5469 Ph: (877) 849-4917 | Iyar Medical Pc 7235 112th St Suite # Pr9, Forest Hills NY 11375-5469 Ph: (877) 849-4917 |
| NPI Number | 1952441420 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952441420 | NPI | - | NPPES |
| 000399390201 | Other | NY | HEALTHPLUS |
| 179953 | Other | NY | ELDERPLAN |
| 268SV1 | Other | NY | EMPIRE BLUE CROSS AND BLU |
| P3725574 | Other | NY | OXFORD |
| PCP ID# 5416260001 | Other | NY | CIGNA |
| 02619565 | Medicaid | NY | |
| 000000119919 | Other | NY | GHI HMO |
| 00002513975 09 | Other | NY | UNITED HEALTHCARE |
| 11P12182 | Other | NY | NY PRESBYTERIAN |
| 233906 | Other | NY | HIP |
| 6C5025 | Other | NY | HEALTHNET |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 233906 (New York) | Primary |
| 225100000X | Physical Therapist | 030904 (New York) | Secondary |
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