| Roosevelt Community Health Center Of Excellence | |
|
3750 72nd St Jackson Heights NY 11372-6143 | |
| (212) 238-7815 | |
| (212) 238-7629 |
| Full Name | Roosevelt Community Health Center Of Excellence |
|---|---|
| Speciality | Clinic/Center |
| Location | 3750 72nd St, Jackson Heights, New York |
| Authorized Official Name and Position | Luchy Jackson (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 2122387815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roosevelt Community Health Center Of Excellence 3750 72nd St Jackson Heights NY 11372-6143 Ph: (466) 615-7800 | Roosevelt Community Health Center Of Excellence 3750 72nd St Jackson Heights NY 11372-6143 Ph: (212) 238-7815 |
| NPI Number | 1225765621 |
|---|---|
| Provider Enumeration Date | 08/04/2022 |
| Last Update Date | 01/12/2023 |
| Medicare PECOS PAC ID | 4082800305 |
|---|---|
| Medicare Enrollment ID | O20230418000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225765621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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