| Jeannette Cano-landivar Medical Office Pc | |
|
3747 77th St Jackson Heights NY 11372-6629 | |
| (917) 745-0067 | |
| (917) 745-0099 |
| Full Name | Jeannette Cano-landivar Medical Office Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3747 77th St, Jackson Heights, New York |
| Authorized Official Name and Position | Jeannette Cano-landivar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7187094721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannette Cano-landivar Medical Office Pc 10119 Jamaica Ave Richmond Hill NY 11418-2008 Ph: (718) 709-4721 | Jeannette Cano-landivar Medical Office Pc 3747 77th St Jackson Heights NY 11372-6629 Ph: (917) 745-0067 |
| NPI Number | 1558942243 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/15/2021 |
| Medicare PECOS PAC ID | 6608252648 |
|---|---|
| Medicare Enrollment ID | O20220929000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558942243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeannette E Cano Landivar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538447438 PECOS PAC ID: 5496037343 Enrollment ID: I20170127001849 |
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