| Prime Care Medical Group Pc | |
|
16806 Hillside Ave Jamaica NY 11432-4341 | |
| (718) 739-7400 | |
| (718) 739-7413 |
| Full Name | Prime Care Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16806 Hillside Ave, Jamaica, New York |
| Authorized Official Name and Position | Iffat Ara Sadique (OWNER) |
| Authorized Official Contact | 7187397400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Care Medical Group Pc 16806 Hillside Ave Jamaica NY 11432-4341 Ph: (718) 739-7400 | Prime Care Medical Group Pc 16806 Hillside Ave Jamaica NY 11432-4341 Ph: (718) 739-7400 |
| NPI Number | 1740461334 |
|---|---|
| Provider Enumeration Date | 11/25/2007 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 6608923628 |
|---|---|
| Medicare Enrollment ID | O20090409000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740461334 | NPI | - | NPPES |
| 02585142 | Medicaid | NY | |
| 02491972 | Medicaid | NY | |
| 02802188 | Medicaid | NY | |
| 02888186 | Medicaid | NY |
| Provider Name | Iffat A Sadique |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104845155 PECOS PAC ID: 2961451075 Enrollment ID: I20050115000024 |
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